Provider Demographics
NPI:1194885210
Name:ROMANELLI, JULIE MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:ROMANELLI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 104TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5118
Mailing Address - Country:US
Mailing Address - Phone:630-904-7100
Mailing Address - Fax:630-904-7111
Practice Address - Street 1:1048 104TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-904-7100
Practice Address - Fax:630-904-7111
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019024141122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist