Provider Demographics
NPI:1326303298
Name:CHANG, JULIA YU FONG (DDS, PHD, MSC)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:YU FONG
Last Name:CHANG
Suffix:
Gender:F
Credentials:DDS, PHD, MSC
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Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BOX 357133
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7133
Mailing Address - Country:US
Mailing Address - Phone:206-543-4440
Mailing Address - Fax:206-543-8054
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:ROOM B-202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7133
Practice Address - Country:US
Practice Address - Phone:206-543-4440
Practice Address - Fax:206-543-8054
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WADE602931921223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology