Provider Demographics
NPI:1205852951
Name:BOZIDAR L KULJIC, DDS PC
Entity Type:Organization
Organization Name:BOZIDAR L KULJIC, DDS PC
Other - Org Name:KULJIC DDS & TEAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BOZIDOAR
Authorized Official - Middle Name:LUKA
Authorized Official - Last Name:KULJIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-922-4200
Mailing Address - Street 1:900 CUMMINGS CENTER
Mailing Address - Street 2:SUITE 106T
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915
Mailing Address - Country:US
Mailing Address - Phone:978-922-4200
Mailing Address - Fax:978-922-1288
Practice Address - Street 1:900 CUMMINGS CENTER
Practice Address - Street 2:SUITE 106T
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:978-922-4200
Practice Address - Fax:978-922-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195111223G0001X
MA213211223G0001X
MA190421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty