Individual
JULIE A GASKILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
546 PARK ST, SUITE 500, BOWLING GREEN, KY 42101
(270) 843-6891
(270) 843-4469
Mailing address
546 PARK ST, SUITE 500, BOWLING GREEN, KY 42101
(270) 843-6891
(270) 843-4469
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6532
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6532
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000069019
ANTHEM
KY
01
—
60065323
MEDICAID DENTAL
KY
05
—
64065329
—
KY
Enumeration date
08/30/2006
Last updated
12/18/2007
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