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General NPI Number Information
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NPI Number | 1043403207
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Entity Type | Organization
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Legal Business Name | ROBERT S JULIAN DDS MD INC
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 290 N WAYTE LN
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City | FRESNO
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State | CA
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Zip | 93701-2124
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Country | US
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Telephone | 559-459-4101
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Fax | 559-459-5744
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Provider Business Mailing Address
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Address Line | 290 N WAYTE LN
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City | FRESNO
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State | CA
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Zip | 93701-2124
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Country | US
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Telephone | 559-459-4101
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Fax | 559-459-5744
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ROBERT S JULIAN III
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Credential | D.D.S., M.D.
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Telephone | 559-459-4101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 36161
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 36161
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 36161
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | A063394
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | A063994
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | A063994
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | A63994
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License Number State | CA
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