Provider Demographics
NPI:1700948809
Name:JULIE L GREENLAW DDS APC
Entity Type:Organization
Organization Name:JULIE L GREENLAW DDS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GREENLAW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-934-1340
Mailing Address - Street 1:112 LA CASA VIA
Mailing Address - Street 2:#202
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3091
Mailing Address - Country:US
Mailing Address - Phone:925-934-1340
Mailing Address - Fax:925-256-7790
Practice Address - Street 1:112 LA CASA VIA
Practice Address - Street 2:SUITE 202
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3091
Practice Address - Country:US
Practice Address - Phone:925-934-1340
Practice Address - Fax:925-256-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA411791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty