Provider Demographics
NPI:1043371735
Name:PASTAGIA, JULIE
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:PASTAGIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 WASHINGTON ST
Mailing Address - Street 2:UNIT 102 C/O SELIGMAN DENTAL DESIGNS
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2131
Mailing Address - Country:US
Mailing Address - Phone:617-451-0011
Mailing Address - Fax:617-451-0012
Practice Address - Street 1:1180 WASHINGTON ST
Practice Address - Street 2:UNIT 102 C/O SELIGMAN DENTAL DESIGNS
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2131
Practice Address - Country:US
Practice Address - Phone:617-451-0011
Practice Address - Fax:617-451-0012
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics