Provider Demographics
NPI:1508977273
Name:GERMAN, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5481 SW 60TH ST
Mailing Address - Street 2:#202
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7698
Mailing Address - Country:US
Mailing Address - Phone:352-653-3161
Mailing Address - Fax:352-414-5754
Practice Address - Street 1:1010 NW 76TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6747
Practice Address - Country:US
Practice Address - Phone:352-332-4180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN163421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice