Provider Demographics
NPI:1700968435
Name:DAVILA, JULIAN E (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:E
Last Name:DAVILA
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8140 OAKLANDON RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9543
Mailing Address - Country:US
Mailing Address - Phone:317-823-8338
Mailing Address - Fax:317-823-8420
Practice Address - Street 1:8140 OAKLANDON RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9543
Practice Address - Country:US
Practice Address - Phone:317-823-8338
Practice Address - Fax:317-823-8420
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011389A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics