Provider Demographics
NPI:1861502163
Name:JONG, JULIE Y (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:Y
Last Name:JONG
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 1:600 ROUTE 73 N
Mailing Address - Street 2:SUITE 9B
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1603
Mailing Address - Country:US
Mailing Address - Phone:856-983-7730
Mailing Address - Fax:856-988-3737
Practice Address - Street 1:600 ROUTE 73 N
Practice Address - Street 2:SUITE 9B
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1603
Practice Address - Country:US
Practice Address - Phone:856-983-7730
Practice Address - Fax:856-988-3737
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102145400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist