MEDICARE: JULIAN W. BEHNER DMD, PA

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	15624	FL

General Provider Information

NPI Number	:	1063538130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIAN W. BEHNER DMD, PA

Provider Business Mailing Address
First Line	:	2766 TEAK PL
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1814
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	934 E ALTAMONTE DR
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5051
Country	:	US
Telephone Number	:	407-831-5455
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	JULIAN BEHNER
Credential	:
Telephone Number	:	407-831-5455

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/22/2020

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