Healthcare Provider Details

I. General information

NPI: 1780217612
Provider Name (Legal Business Name): JULIE N MONROY DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E SAGINAW ST
LANSING MI
48912-2326
US

IV. Provider business mailing address

1801 E SAGINAW ST
LANSING MI
48912-2326
US

V. Phone/Fax

Practice location:
  • Phone: 517-487-1190
  • Fax: 517-487-9611
Mailing address:
  • Phone: 517-487-1190
  • Fax: 517-487-9611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIE NICOLE MONROY
Title or Position: OWNER
Credential: DDS
Phone: 810-923-5868