Provider Demographics
NPI:1710224886
Name:BARBAGALLO, JULIA B (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:B
Last Name:BARBAGALLO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-1247
Mailing Address - Country:US
Mailing Address - Phone:978-387-7345
Mailing Address - Fax:
Practice Address - Street 1:12 MORGAN DR
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-1247
Practice Address - Country:US
Practice Address - Phone:978-387-7345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18563111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice