Provider Demographics
NPI:1609921105
Name:WYMAN, JUILANNE MORGAN (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:JUILANNE
Middle Name:MORGAN
Last Name:WYMAN
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 E PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6430
Mailing Address - Country:US
Mailing Address - Phone:410-398-1221
Mailing Address - Fax:410-398-9970
Practice Address - Street 1:132 E PULASKI HWY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6430
Practice Address - Country:US
Practice Address - Phone:410-398-1221
Practice Address - Fax:410-398-9970
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics