Tullis, Justin
Tullis, Justin is an sole proprietor health care provider with primary practice located at 320 E Fontanero St Ste 307 , Colorado Springs CO 80907-7526. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Periodontics. Dental Providers / Periodontics is his primary health care specialty. Tullis, Justin can be contacted via phone (719) 475-9023.Contact Information
Primary practice address
320 E Fontanero St Ste 307
Colorado Springs CO 80907-7526
Phone: (719) 475-9023
Fax: (719) 475-9009
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | Missouri | |
Dental Providers / Periodontics | 1223P0300X | 204256 | Colorado |
Profile Details
NPI number | 1497115752 |
---|---|
LBN Legal business name | Tullis, Justin |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 1st, 2016 |
Last updated | Jan 19th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1497115752 | NPPES |
Colorado | Other | 204256 | DENTAL LICENSE NUMBER |
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