Provider Demographics
NPI:1043568777
Name:CHA, JULIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:CHA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 W MARKET ST APT 1
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-5481
Mailing Address - Country:US
Mailing Address - Phone:617-230-4815
Mailing Address - Fax:
Practice Address - Street 1:1629 W MARKET ST APT 1
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-5481
Practice Address - Country:US
Practice Address - Phone:617-230-4815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0392611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice