Provider Demographics
NPI:1881761336
Name:ROBERTS, JULIE SPETTEL (DDS)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:SPETTEL
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857
Mailing Address - Country:US
Mailing Address - Phone:419-668-1317
Mailing Address - Fax:419-663-9694
Practice Address - Street 1:107 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857
Practice Address - Country:US
Practice Address - Phone:419-668-1317
Practice Address - Fax:419-663-9694
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300185461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice