Healthcare Provider Details

I. General information

NPI: 1205051802
Provider Name (Legal Business Name): JOSEPH STEPHEN HOARD IV DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 A S GLENBURNIE ROAD
NEW BERN NC
28562
US

IV. Provider business mailing address

1421 A S GLENBURNIE ROAD
NEW BERN NC
28562
US

V. Phone/Fax

Practice location:
  • Phone: 252-633-9800
  • Fax: 252-633-2327
Mailing address:
  • Phone: 252-633-9800
  • Fax: 252-633-2327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5786
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: