Provider Demographics
NPI:1336701697
Name:DRISCOLL, JULIE (DMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 VILLAGE CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7568
Mailing Address - Country:US
Mailing Address - Phone:919-604-3411
Mailing Address - Fax:
Practice Address - Street 1:1016 VILLAGE CROSSING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7568
Practice Address - Country:US
Practice Address - Phone:919-604-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-07
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC51250122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist