| Robert S Julian Dds Md Inc | |
|
290 N Wayte Ln Fresno CA 93701-2124 | |
| (559) 459-4101 | |
| (559) 459-5744 |
| Full Name | Robert S Julian Dds Md Inc |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 290 N Wayte Ln, Fresno, California |
| Authorized Official Name and Position | Robert S Julian (PRESIDENT/OWNER) |
| Authorized Official Contact | 5594594101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert S Julian Dds Md Inc 290 N Wayte Ln Fresno CA 93701-2124 Ph: (559) 459-4101 | Robert S Julian Dds Md Inc 290 N Wayte Ln Fresno CA 93701-2124 Ph: (559) 459-4101 |
| NPI Number | 1043403207 |
|---|---|
| Provider Enumeration Date | 08/21/2007 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 6800062506 |
|---|---|
| Medicare Enrollment ID | O20111230000180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043403207 | NPI | - | NPPES |
| 1043403207 | Other | CA | MEDICARE - BILLING PROV |
| 1427119791 | Other | CA | MEDICARE - RENDERING/INDIVIDUAL PROV |
| 36161 | Medicaid | CA | |
| 63994 | Medicaid | CA | |
| 36161 | Other | CA | DENTAL LICENSE |
| B36161 | Other | CA | DENTI-CAL TX PROV |
| GA 1120 | Other | CA | GENERAL ANESTHESIA LIC |
| A063994 | Other | CA | MEDICAL LICENSE |
| B36161-01 | Other | CA | DENTI-CAL BILLING PROV. |
| $$$$$$$$$ | Other | CA | SOCIAL SECURITY NUMBER |
| Provider Name | Robert S Julian |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1427119791 PECOS PAC ID: 9234305939 Enrollment ID: I20120103000111 |
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