Provider Demographics
NPI:1700978624
Name:TULKKI, MICHAEL JOHN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:TULKKI
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:101 LAKE ST W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1576
Mailing Address - Country:US
Mailing Address - Phone:952-476-0070
Mailing Address - Fax:952-476-0051
Practice Address - Street 1:101 LAKE ST W
Practice Address - Street 2:SUITE 100
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1576
Practice Address - Country:US
Practice Address - Phone:952-476-0070
Practice Address - Fax:952-476-0051
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2016-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MND115431223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics