Provider Demographics
NPI:1487028031
Name:JULIA ANN ROUTHIER DMD LLC
Entity Type:Organization
Organization Name:JULIA ANN ROUTHIER DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROUTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-352-7808
Mailing Address - Street 1:1 MALL TERRRACE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2566
Mailing Address - Country:US
Mailing Address - Phone:912-352-7808
Mailing Address - Fax:
Practice Address - Street 1:1 MALL TER
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3602
Practice Address - Country:US
Practice Address - Phone:912-352-9120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0122051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7521060001Medicare NSC