Provider Demographics
NPI:1548995376
Name:ULIANI, EDWARD FARIAS (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:FARIAS
Last Name:ULIANI
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 1:209 BLACKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-7501
Mailing Address - Country:US
Mailing Address - Phone:239-297-2858
Mailing Address - Fax:
Practice Address - Street 1:2320 W LOOP 340 STE 200B
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76711-2454
Practice Address - Country:US
Practice Address - Phone:254-230-9597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist