Individual
DR. JUILI SUBODH SHIVDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MS, BDS
Contact information
Practice address
1260 MILTON AVE STE 140, JANESVILLE, WI 53545-1890
(608) 757-0057
Mailing address
701 MYRTLE WAY APT 112, JANESVILLE, WI 53545-9115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6001032-15
WI
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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