Provider Demographics
NPI:1255437281
Name:PHILLIPS, JULIE ANNE (DDS MS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANNE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:TOWLES
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:408-B PARKWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-274-5400
Mailing Address - Fax:336-274-5493
Practice Address - Street 1:408-B PARKWAY AVENUE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-274-5400
Practice Address - Fax:336-274-5493
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67791223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics