Provider Demographics
NPI:1962681528
Name:LISA M JUELS DMD PC
Entity Type:Organization
Organization Name:LISA M JUELS DMD PC
Other - Org Name:JUELS DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUELS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:636-477-1000
Mailing Address - Street 1:100 PIPER HILL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1616
Mailing Address - Country:US
Mailing Address - Phone:636-477-1000
Mailing Address - Fax:
Practice Address - Street 1:100 PIPER HILL DR
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1616
Practice Address - Country:US
Practice Address - Phone:636-477-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty