MEDICARE: DR. JULIE BETH SKOBY DMD

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	DN11367	FL

General Provider Information

NPI Number	:	1376542043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE BETH SKOBY DMD

Provider Business Mailing Address
First Line	:	3721 NW 40TH TER
Second Line	:	SUITE A
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6182
Country	:	US
Telephone Number	:	352-377-5757
Fax Number	:	352-335-3200

Provider Business Practice Location Address
First Line	:	3721 NW 40TH TER
Second Line	:	SUITE A
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6182
Country	:	US
Telephone Number	:	352-377-5757
Fax Number	:	352-335-3200

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/08/2007

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