Individual
JULIENNE ROSE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS025179L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008198
DORAL UPMC BEST
—
01
—
0010512380001
MEDICAL ASSISTANCE
PA
01
—
068391
THREE RIVERS HEALTH PLAN
—
01
—
242531
DENTAL BENEFIT PROVIDERS
—
01
—
5040169
AETNA
—
01
—
F0427795
BS BS UNITED CONCORDIA
PA
Enumeration date
12/06/2005
Last updated
12/11/2014
Update your record
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