Provider Demographics
NPI:1679604110
Name:JULIANI, DAVID M (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:JULIANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1202 WALTON BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6918
Mailing Address - Country:US
Mailing Address - Phone:248-651-2273
Mailing Address - Fax:248-651-2976
Practice Address - Street 1:441 S LIVERNOIS RD
Practice Address - Street 2:SUITE 185
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2584
Practice Address - Country:US
Practice Address - Phone:248-651-2273
Practice Address - Fax:248-651-2976
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI164531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI383453336OtherTAX ID