# JULIA M GUDMUNDSEN PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144622655
- **Authorized official:** DR. JULIA MARY GUDMUNDSEN DDS (PRESIDENT)
- **Authorized official phone:** (517) 321-2358

## Contact information

- **Practice address:** 5001 W ST JOE HWY, LANSING, MI 48917-4023
- **Practice address phone:** (517) 321-2358
- **Practice address fax:** (517) 321-4420
- **Mailing address:** 5001 W ST JOE HWY, LANSING, MI 48917-4023
- **Mailing address phone:** (517) 321-2358
- **Mailing address fax:** (517) 321-4420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 15606 | MI | Yes |

## Other

- **Enumeration date:** 09/16/2014
- **Last updated:** 09/16/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1063597300 | NPPES | MI |