Provider Demographics
NPI:1295186369
Name:LOVE, JULIA BLAIR POWELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:BLAIR POWELL
Last Name:LOVE
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 1:1600 HARRISON AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3149
Mailing Address - Country:US
Mailing Address - Phone:914-381-5228
Mailing Address - Fax:
Practice Address - Street 1:1600 HARRISON AVE STE 106
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3149
Practice Address - Country:US
Practice Address - Phone:914-381-5228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0595231223G0001X
NJ22DI026958001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice