Provider Demographics
NPI:1700960259
Name:BULNES-NEWTON, JULIET SUZANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIET
Middle Name:SUZANNE
Last Name:BULNES-NEWTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10131 WILSKY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-5837
Mailing Address - Country:US
Mailing Address - Phone:813-792-8211
Mailing Address - Fax:813-792-9722
Practice Address - Street 1:10131 WILSKY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5117
Practice Address - Country:US
Practice Address - Phone:813-792-8211
Practice Address - Fax:813-792-9722
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL158081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL205368597OtherTAX IDENTIFICATION NUMER