Basic Information
| Provider Information | |||||||||
| NPI: | 1487681680 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COMER | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | RAINES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3842 BRIARCLIFF RD NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303453857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043213877 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | VAMC (160) DENTAL SERVICE | ||||||||
| Address2: | 1670 CLAIRMONT RD. | ||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043216111 | ||||||||
| FaxNumber: | 4047285065 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 10308 | GA | Y | Dental Providers | Dentist |
No ID Information.