Provider Demographics
NPI:1538313366
Name:GULICK & GULICK D.D.S., P.C.
Entity Type:Organization
Organization Name:GULICK & GULICK D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GULICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-676-5900
Mailing Address - Street 1:1103 S CEDAR ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-2081
Mailing Address - Country:US
Mailing Address - Phone:517-676-5900
Mailing Address - Fax:517-676-5877
Practice Address - Street 1:1103 S CEDAR ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-2081
Practice Address - Country:US
Practice Address - Phone:517-676-5900
Practice Address - Fax:517-676-5877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12796122300000X
MI12797122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty