Healthcare Provider Details

I. General information

NPI: 1770077687
Provider Name (Legal Business Name): JOSHUA KYLE STAMPER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SUNSET BLVD
STEUBENVILLE OH
43952-1158
US

IV. Provider business mailing address

2700 SUNSET BLVD
STEUBENVILLE OH
43952-1158
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-6811
  • Fax: 740-264-6812
Mailing address:
  • Phone: 740-485-0309
  • Fax: 740-264-6812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.025494
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: