=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053223073
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE BRULOTTE RDH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2026
-----------------------------------------------------
Last Update Date | 09/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26 MAIN ST
-----------------------------------------------------
City | LIMERICK
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04048-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-432-0248
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 74
-----------------------------------------------------
City | LIMERICK
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04048-0074
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | RDH4100
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------