Provider Demographics
NPI:1851512123
Name:STULIC, DOSITEJ (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOSITEJ
Middle Name:
Last Name:STULIC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE F600
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4660
Mailing Address - Country:US
Mailing Address - Phone:602-978-5900
Mailing Address - Fax:602-978-5909
Practice Address - Street 1:5750 W THUNDERBIRD RD
Practice Address - Street 2:SUITE F600
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4660
Practice Address - Country:US
Practice Address - Phone:602-978-5900
Practice Address - Fax:602-978-5909
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7132122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist