Provider Demographics
NPI:1346381167
Name:MOSENG, JULIE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:MOSENG
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 1:601 MCHUGH RD
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636
Mailing Address - Country:US
Mailing Address - Phone:608-526-9300
Mailing Address - Fax:608-526-9310
Practice Address - Street 1:601 MCHUGH RD
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636
Practice Address - Country:US
Practice Address - Phone:608-526-9300
Practice Address - Fax:608-526-9310
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist