MEDICARE: JOSHUA GEORGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	38573	TX

General Provider Information

NPI Number	:	1467182097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA GEORGE

Provider Business Mailing Address
First Line	:	8610 LAUREL CANYON RD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-3921
Country	:	US
Telephone Number	:	972-898-5733
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 MARKET PLACE BLVD STE 140
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-8098
Country	:	US
Telephone Number	:	469-747-2404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2022
Last Update Date	:	06/16/2022

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Directions to “ JOSHUA GEORGE ” Practice Location

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