MEDICARE: JULIANNE CHRISTINE DOTY

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	1223G0001X	General Practice Dentistry	7118	NV

General Provider Information

NPI Number	:	1679054662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNE CHRISTINE DOTY

Provider Business Mailing Address
First Line	:	8071 LANDS END AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7635
Country	:	US
Telephone Number	:	702-234-9459
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 E SUNSET RD STE 100
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2238
Country	:	US
Telephone Number	:	702-465-8187
Fax Number	:

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

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	08/27/2018

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Directions to “ JULIANNE CHRISTINE DOTY ” Practice Location

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