Provider Demographics
NPI:1386080174
Name:LEBLANC, JULIE NICOLE (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:NICOLE
Last Name:LEBLANC
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 1:8029 S JASMINE CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6609
Mailing Address - Country:US
Mailing Address - Phone:303-809-2210
Mailing Address - Fax:
Practice Address - Street 1:10000 COMMONS ST
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5501
Practice Address - Country:US
Practice Address - Phone:303-662-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry