Provider Demographics
NPI:1770535429
Name:KULJIS, LAWRENCE MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MICHAEL
Last Name:KULJIS
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 1:8200 E BELLEVIEW AVE
Mailing Address - Street 2:STE 465
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2828
Mailing Address - Country:US
Mailing Address - Phone:303-691-2555
Mailing Address - Fax:
Practice Address - Street 1:8200 E BELLEVIEW AVENUE
Practice Address - Street 2:SUITE 465
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-771-7326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist