Healthcare Provider Details

I. General information

NPI: 1962192997
Provider Name (Legal Business Name): JULIA WITT DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 MAIN ST
HOLDEN MA
01520-1090
US

IV. Provider business mailing address

1406 MAIN ST
HOLDEN MA
01520-1090
US

V. Phone/Fax

Practice location:
  • Phone: 508-829-7650
  • Fax:
Mailing address:
  • Phone: 774-364-4819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN10001616
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: