Provider Demographics
NPI:1942077235
Name:JULIE E MCNEISH DMD MD LLC
Entity Type:Organization
Organization Name:JULIE E MCNEISH DMD MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MCNEISH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:203-596-7788
Mailing Address - Street 1:650 CHASE PKWY
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3046
Mailing Address - Country:US
Mailing Address - Phone:203-596-7788
Mailing Address - Fax:203-596-7194
Practice Address - Street 1:650 CHASE PKWY
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3046
Practice Address - Country:US
Practice Address - Phone:203-596-7788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty