Provider Demographics
NPI:1548309735
Name:BUCHANAN, JULIE M (DDS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:BUCHANAN
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 1:781 E 700 S
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4027
Mailing Address - Country:US
Mailing Address - Phone:435-628-6168
Mailing Address - Fax:
Practice Address - Street 1:781 E 700 S
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-4027
Practice Address - Country:US
Practice Address - Phone:435-628-6168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT533463399221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice