Provider Demographics
NPI:1255455150
Name:KARDON, JULIE (DMD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KARDON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 KINGS HWY N
Mailing Address - Street 2:SUTIE A
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1009
Mailing Address - Country:US
Mailing Address - Phone:856-667-1001
Mailing Address - Fax:856-667-1001
Practice Address - Street 1:94 KINGS HWY N
Practice Address - Street 2:SUTIE A
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1009
Practice Address - Country:US
Practice Address - Phone:856-667-1001
Practice Address - Fax:856-667-1001
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ19582122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist