Provider Demographics
NPI:1447399613
Name:CONNOLLY, JULIE ANNE (DDS, MPH, MS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANNE
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:DDS, MPH, MS
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Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8183
Mailing Address - Country:US
Mailing Address - Phone:212-888-7477
Mailing Address - Fax:212-758-8451
Practice Address - Street 1:654 MADISON AVE
Practice Address - Street 2:SUITE 1005
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8404
Practice Address - Country:US
Practice Address - Phone:212-888-7477
Practice Address - Fax:212-758-8451
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY050465-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics