Provider Demographics
NPI:1144204348
Name:WALDER, JULIE TOLVE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:TOLVE
Last Name:WALDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:T
Other - Last Name:WALDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:971 ROUTE 45
Mailing Address - Street 2:SUITE 102
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3500
Mailing Address - Country:US
Mailing Address - Phone:845-354-6969
Mailing Address - Fax:
Practice Address - Street 1:971 ROUTE 45
Practice Address - Street 2:SUITE 102
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3500
Practice Address - Country:US
Practice Address - Phone:845-354-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051475122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist