Provider Demographics
NPI:1326160938
Name:GO, JULIA S (DDS)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:S
Last Name:GO
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 1:161 S HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91745
Mailing Address - Country:US
Mailing Address - Phone:626-968-9601
Mailing Address - Fax:626-968-9603
Practice Address - Street 1:161 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91745
Practice Address - Country:US
Practice Address - Phone:626-968-9601
Practice Address - Fax:626-968-9603
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27286122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist