MEDICARE: DR. JULIE LEA LEBELL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5807	LA

General Provider Information

NPI Number	:	1124220728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE LEA LEBELL D.D.S.

Provider Business Mailing Address
First Line	:	3301 STERLINGTON RD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203-2521
Country	:	US
Telephone Number	:	318-325-3254
Fax Number	:	318-398-9444

Provider Business Practice Location Address
First Line	:	3301 STERLINGTON RD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203-2521
Country	:	US
Telephone Number	:	318-325-3254
Fax Number	:	318-398-9444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	07/08/2007

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