Provider Demographics
NPI:1801928205
Name:JULIE MOL DDS, MS, PA
Entity type:Organization
Organization Name:JULIE MOL DDS, MS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:HUH
Authorized Official - Last Name:MOL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:919-405-7111
Mailing Address - Street 1:5726 FAYETTEVILLE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6296
Mailing Address - Country:US
Mailing Address - Phone:919-405-7111
Mailing Address - Fax:919-405-7222
Practice Address - Street 1:5726 FAYETTEVILLE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6296
Practice Address - Country:US
Practice Address - Phone:919-405-7111
Practice Address - Fax:919-405-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1074671223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty