Provider Demographics
NPI:1487681680
Name:COMER, JULIA RAINES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:RAINES
Last Name:COMER
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 1:3842 BRIARCLIFF RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3857
Mailing Address - Country:US
Mailing Address - Phone:404-321-3877
Mailing Address - Fax:
Practice Address - Street 1:VAMC (160) DENTAL SERVICE
Practice Address - Street 2:1670 CLAIRMONT RD.
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-728-5065
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10308122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist