Provider Demographics
NPI:1427342914
Name:LEBOEUF, JULIE A (RDH)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:LEBOEUF
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 MONTAGUE CITY RD
Mailing Address - Street 2:
Mailing Address - City:TURNERS FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01376-1830
Mailing Address - Country:US
Mailing Address - Phone:413-772-3748
Mailing Address - Fax:
Practice Address - Street 1:338 MONTAGUE CITY RD
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1830
Practice Address - Country:US
Practice Address - Phone:413-772-3748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH11089124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist