Provider Demographics
NPI:1689807745
Name:JULIAN, ANGELINE C (DDS)
Entity Type:Individual
Prefix:
First Name:ANGELINE
Middle Name:C
Last Name:JULIAN
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 1:4302 TODDINGTON LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6364
Mailing Address - Country:US
Mailing Address - Phone:916-396-2041
Mailing Address - Fax:
Practice Address - Street 1:3661 SCORPIO DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3537
Practice Address - Country:US
Practice Address - Phone:916-396-2041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA586801223G0001X
TX251371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice