Provider Demographics
NPI:1467545277
Name:GLUD, JULIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:GLUD
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 1:120 E SAINT CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2303
Mailing Address - Country:US
Mailing Address - Phone:616-485-0765
Mailing Address - Fax:630-613-9760
Practice Address - Street 1:120 E SAINT CHARLES RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2303
Practice Address - Country:US
Practice Address - Phone:616-485-0765
Practice Address - Fax:630-613-9760
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190275081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice