Provider Demographics
NPI:1386795730
Name:ROHLEDER, JULIA ANNELLE (DMD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ANNELLE
Last Name:ROHLEDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N TEJON ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1405
Mailing Address - Country:US
Mailing Address - Phone:719-260-0216
Mailing Address - Fax:
Practice Address - Street 1:105 N TEJON ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1405
Practice Address - Country:US
Practice Address - Phone:719-260-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO82101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice