MEDICARE: DR. DAVID M JULIANI 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	1223G0001X	General Practice Dentistry	16453	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	383453336	OTHER	MI	TAX ID

General Provider Information

NPI Number	:	1679604110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID M JULIANI D.D.S

Provider Business Mailing Address
First Line	:	1202 WALTON BLVD
Second Line	:	STE 204
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-6918
Country	:	US
Telephone Number	:	248-651-2273
Fax Number	:	248-651-2976

Provider Business Practice Location Address
First Line	:	441 S LIVERNOIS RD
Second Line	:	SUITE 185
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2584
Country	:	US
Telephone Number	:	248-651-2273
Fax Number	:	248-651-2976

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	04/04/2017

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