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General NPI Number Information
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NPI Number | 1003980491
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Entity Type | Individual
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Provider Name | JULIE NEAL FORSTADT D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 763 BROADWAY
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City | SONOMA
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State | CA
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Zip | 95476-7010
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Country | US
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Telephone | 707-938-8528
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Fax |
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Provider Business Mailing Address
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Address Line | 1224 CARRELL LN
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City | NAPA
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State | CA
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Zip | 94558-1007
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Country | US
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Telephone | 707-224-4752
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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 | 37549
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License Number State | CA
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