Healthcare Provider Details

I. General information

NPI: 1275389009
Provider Name (Legal Business Name): VARONICA Y JOSEPH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 07/04/2024
Certification Date: 07/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NEWNAN CROSSING BYP
NEWNAN GA
30265-1063
US

IV. Provider business mailing address

10326 NW 7TH ST
CORAL SPRINGS FL
33071-6856
US

V. Phone/Fax

Practice location:
  • Phone: 678-621-6410
  • Fax:
Mailing address:
  • Phone: 954-892-7204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN123458
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: