Provider Demographics
NPI:1407631872
Name:ULYSSE, NELTHIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NELTHIE
Middle Name:
Last Name:ULYSSE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6491 WETLAND DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7241
Mailing Address - Country:US
Mailing Address - Phone:561-900-6727
Mailing Address - Fax:
Practice Address - Street 1:6617 BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3526
Practice Address - Country:US
Practice Address - Phone:561-735-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28538122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist