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General NPI Number Information
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NPI Number | 1003023722
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Entity Type | Individual
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Provider Name | JULIA DISON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 660 NE 95TH ST
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2758
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Country | US
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Telephone | 305-758-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 991 CORKWOOD ST
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City | HOLLYWOOD
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State | FL
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Zip | 33019-4878
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Country | US
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Telephone | 954-801-7470
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 16703
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License Number State | FL
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