Healthcare Provider Details

I. General information

NPI: 1376542043
Provider Name (Legal Business Name): JULIE BETH SKOBY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3721 NW 40TH TER SUITE A
GAINESVILLE FL
32606-6182
US

IV. Provider business mailing address

3721 NW 40TH TER SUITE A
GAINESVILLE FL
32606-6182
US

V. Phone/Fax

Practice location:
  • Phone: 352-377-5757
  • Fax: 352-335-3200
Mailing address:
  • Phone: 352-377-5757
  • Fax: 352-335-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN11367
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: