MEDICARE: DR. JULIE S WEE 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	1223P0221X	Pediatric Dentistry	050476	NY

General Provider Information

NPI Number	:	1093728768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE S WEE DDS

Provider Business Mailing Address
First Line	:	3201 GRAND CONCOURSE
Second Line	:	SUITE #1E
City	:	BRONX
State	:	NY
Zip	:	10468-1247
Country	:	US
Telephone Number	:	718-367-7645
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 GRAND CONCOURSE
Second Line	:	SUITE #1E
City	:	BRONX
State	:	NY
Zip	:	10468-1247
Country	:	US
Telephone Number	:	718-367-7645
Fax Number	:

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	12/11/2008

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