Provider Demographics
NPI:1528275708
Name:DUDEVOIR-BADGER, JULIE ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:DUDEVOIR-BADGER
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 1:7 GREENWOOD AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-6130
Mailing Address - Country:US
Mailing Address - Phone:603-447-6707
Mailing Address - Fax:603-447-8376
Practice Address - Street 1:21A POLIQUIN DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-5802
Practice Address - Country:US
Practice Address - Phone:603-447-6707
Practice Address - Fax:603-452-9051
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03940122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3080677Medicaid
NH03940OtherNH DENTAL LICENSE