Provider Demographics
NPI:1013101096
Name:GIULIANI, ROBERT P (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:GIULIANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 E MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5724
Mailing Address - Country:US
Mailing Address - Phone:530-272-4201
Mailing Address - Fax:530-272-4202
Practice Address - Street 1:1061 E MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5724
Practice Address - Country:US
Practice Address - Phone:530-272-4201
Practice Address - Fax:530-272-4202
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA25528OtherCA DENTAL LICENSE