Provider Demographics
NPI:1467677021
Name:JULIANO, BRETT DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:DAVID
Last Name:JULIANO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 MEADOWS ROAD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486
Mailing Address - Country:US
Mailing Address - Phone:561-392-9766
Mailing Address - Fax:561-392-6121
Practice Address - Street 1:801 MEADOWS ROAD
Practice Address - Street 2:SUITE 115
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-392-9766
Practice Address - Fax:561-392-6121
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist