Provider Demographics
NPI:1114030582
Name:JULIA-MONTANEZ, MARIA D (DMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:JULIA-MONTANEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:D
Other - Last Name:JULIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 MCHUGH BLVD
Mailing Address - Street 2:PSC BOX 20130
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-2511
Mailing Address - Country:US
Mailing Address - Phone:910-451-2208
Mailing Address - Fax:910-451-8036
Practice Address - Street 1:100 WHITE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540
Practice Address - Country:US
Practice Address - Phone:910-449-6515
Practice Address - Fax:910-449-6077
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice