Provider Demographics
NPI:1407223340
Name:PATIL, JULITA (DDS)
Entity Type:Individual
Prefix:
First Name:JULITA
Middle Name:
Last Name:PATIL
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 1:2991 TREAT BLVD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3616
Mailing Address - Country:US
Mailing Address - Phone:925-689-2585
Mailing Address - Fax:925-691-5211
Practice Address - Street 1:2991 TREAT BLVD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3616
Practice Address - Country:US
Practice Address - Phone:925-689-2585
Practice Address - Fax:925-691-5211
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice