Provider Demographics
NPI:1093825168
Name:MCGHEE, JULIE (DDS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8275 SIERRA AVENUE
Mailing Address - Street 2:STE 102
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335
Mailing Address - Country:US
Mailing Address - Phone:909-823-7567
Mailing Address - Fax:909-823-8341
Practice Address - Street 1:8275 SIERRA AVENUE
Practice Address - Street 2:STE 102
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335
Practice Address - Country:US
Practice Address - Phone:909-823-7567
Practice Address - Fax:909-823-8341
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist