Healthcare Provider Details

I. General information

NPI: 1740407246
Provider Name (Legal Business Name): JULIA MORGAN GOLDEN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA A GOLDEN

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S HUNTINGTON AVE
BOSTON MA
02130
US

IV. Provider business mailing address

103 BEETHOVEN AVE
WABAN MA
02468-1731
US

V. Phone/Fax

Practice location:
  • Phone: 857-364-5156
  • Fax:
Mailing address:
  • Phone: 617-916-1844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS029625L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: