Provider Demographics
NPI:1760811178
Name:MCCARRON, JULIE (DMD, FAGD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MCCARRON
Suffix:
Gender:F
Credentials:DMD, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6905
Mailing Address - Country:US
Mailing Address - Phone:305-296-7801
Mailing Address - Fax:
Practice Address - Street 1:939 FLEMING ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-6905
Practice Address - Country:US
Practice Address - Phone:305-296-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15704122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist