Provider Demographics
NPI:1689875460
Name:FORTE, JULIE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:FORTE
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 1:1130 CATALPA DR
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-2095
Mailing Address - Country:US
Mailing Address - Phone:248-546-2030
Mailing Address - Fax:248-546-8165
Practice Address - Street 1:1130 CATALPA DR
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-2095
Practice Address - Country:US
Practice Address - Phone:248-546-2030
Practice Address - Fax:248-546-8165
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010195571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice