Provider Demographics
NPI:1699826677
Name:PARKS, JULIE LEFFLER (DDS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LEFFLER
Last Name:PARKS
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 1:946 MAJESTIC
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-3575
Mailing Address - Country:US
Mailing Address - Phone:248-650-8016
Mailing Address - Fax:
Practice Address - Street 1:52871 MOUND RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3264
Practice Address - Country:US
Practice Address - Phone:586-739-1717
Practice Address - Fax:586-739-3362
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010167651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice