MEDICARE: DR. DAVID HENRY JUILFS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6323	MD

General Provider Information

NPI Number	:	1043397284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID HENRY JUILFS DDS

Provider Business Mailing Address
First Line	:	14333 LAUREL BOWIE RD
Second Line	:	SUITE 304
City	:	LAUREL
State	:	MD
Zip	:	20708-1183
Country	:	US
Telephone Number	:	301-776-5051
Fax Number	:	301-776-5121

Provider Business Practice Location Address
First Line	:	14333 LAUREL BOWIE RD
Second Line	:	SUITE 304
City	:	LAUREL
State	:	MD
Zip	:	20708-1183
Country	:	US
Telephone Number	:	301-776-5051
Fax Number	:	301-776-5121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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