Provider Demographics
NPI:1326088360
Name:MESSERLY, JULIE DENISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:DENISE
Last Name:MESSERLY
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 1:127 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2550
Mailing Address - Country:US
Mailing Address - Phone:740-687-4484
Mailing Address - Fax:740-687-6150
Practice Address - Street 1:127 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2550
Practice Address - Country:US
Practice Address - Phone:740-687-4484
Practice Address - Fax:740-687-6150
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH214981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2316041Medicaid