Provider Demographics
NPI:1952491763
Name:MILLS, JULIE ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ELIZABETH
Last Name:MILLS
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 1:6466 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-6542
Mailing Address - Country:US
Mailing Address - Phone:716-646-6632
Mailing Address - Fax:
Practice Address - Street 1:744 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2505
Practice Address - Country:US
Practice Address - Phone:716-366-6822
Practice Address - Fax:716-366-4055
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052261-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02701619Medicaid