Healthcare Provider Details

I. General information

NPI: 1205814209
Provider Name (Legal Business Name): ANTHONY PETER JOYCE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4323 HILL ST FT JACKSON DENTAL ACTIVITY - CREDENTIALS
COLUMBIA SC
29207-6022
US

IV. Provider business mailing address

4323 HILL ST FT JACKSON DENTAL ACTIVITY - CREDENTIALS
COLUMBIA SC
29207-6022
US

V. Phone/Fax

Practice location:
  • Phone: 803-751-6213
  • Fax: 803-734-6213
Mailing address:
  • Phone: 803-751-6213
  • Fax: 803-734-6213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number5552
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number5552
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: