Healthcare Provider Details

I. General information

NPI: 1285677195
Provider Name (Legal Business Name): JOSEPH T DUST
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10451 ULMERTON RD
LARGO FL
33771-3530
US

IV. Provider business mailing address

5000 CHESHIRE LN N
PLYMOUTH MN
55446-3706
US

V. Phone/Fax

Practice location:
  • Phone: 727-587-0544
  • Fax: 727-587-0564
Mailing address:
  • Phone: 888-333-9152
  • Fax: 763-268-4240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS246
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: