Provider Demographics
NPI:1831557586
Name:JULIE J STORM DMD PLLC
Entity type:Organization
Organization Name:JULIE J STORM DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:STORM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:405-737-0404
Mailing Address - Street 1:1342 S DOUGLAS BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1342 S DOUGLAS BLVD
Practice Address - Street 2:STE B
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5248
Practice Address - Country:US
Practice Address - Phone:405-737-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6242332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment