Provider Demographics
NPI:1063777175
Name:HALL, JULIANA FOLEGATTI (DDS)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:FOLEGATTI
Last Name:HALL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:FOLEGATTI
Other - Last Name:COLETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1415 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442
Mailing Address - Country:US
Mailing Address - Phone:712-263-5615
Mailing Address - Fax:712-263-8124
Practice Address - Street 1:511 WALKER ST.
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:IA
Practice Address - Zip Code:51579
Practice Address - Country:US
Practice Address - Phone:712-647-3188
Practice Address - Fax:712-647-2941
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60847122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist