Provider Demographics
NPI:1922109537
Name:CLASEN, JULIE K (DDS)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:CLASEN
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 1:1789 WOODLANE DRIVE
Mailing Address - Street 2:CLASEN FAMILY DENTAL SUITE B
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125
Mailing Address - Country:US
Mailing Address - Phone:651-739-0640
Mailing Address - Fax:651-739-0642
Practice Address - Street 1:1789 WOODLANE DRIVE
Practice Address - Street 2:CLASEN FAMILY DENTAL SUITE B
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-739-0640
Practice Address - Fax:651-739-0642
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10506122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN72264OtherHEALTHPARTNERS
MN98D93CLOtherBLUE CROSS