Provider Demographics
NPI:1508122821
Name:AGULLANA, SHEILA ANGELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:ANGELA
Last Name:AGULLANA
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 1:228 S 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:STURGEON BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54235-1000
Mailing Address - Country:US
Mailing Address - Phone:920-746-3788
Mailing Address - Fax:920-743-3340
Practice Address - Street 1:228 S 18TH AVE
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-1000
Practice Address - Country:US
Practice Address - Phone:920-746-3788
Practice Address - Fax:920-743-3340
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014134801223G0001X
DCDEN10010941223G0001X
WI1002212-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice