Healthcare Provider Details

I. General information

NPI: 1972677995
Provider Name (Legal Business Name): JOSEPH R STYLES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 E MINNESOTA ST
SAINT JOSEPH MN
56374-8618
US

IV. Provider business mailing address

1514 E MINNESOTA ST PO BOX 607
SAINT JOSEPH MN
56374-8618
US

V. Phone/Fax

Practice location:
  • Phone: 320-363-7729
  • Fax: 320-363-0308
Mailing address:
  • Phone: 320-363-7729
  • Fax: 320-363-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8370
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: