Individual
STEPHEN A TULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6520 HOLDREGE ST, LINCOLN, NE 68505-1655
(402) 464-1861
(402) 464-1808
Mailing address
6520 HOLDREGE ST, LINCOLN, NE 68505-1655
(402) 464-1861
(402) 464-1808
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5960
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47079006600
—
NE
Enumeration date
11/07/2006
Last updated
07/08/2007
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