Healthcare Provider Details

I. General information

NPI: 1447852587
Provider Name (Legal Business Name): JOSHUA A DUBOSE DMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E MARTINTOWN RD
NORTH AUGUSTA SC
29841-5303
US

IV. Provider business mailing address

501 E MARTINTOWN RD
NORTH AUGUSTA SC
29841-5303
US

V. Phone/Fax

Practice location:
  • Phone: 803-279-4343
  • Fax: 803-279-4378
Mailing address:
  • Phone: 803-279-4343
  • Fax: 803-279-4378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA ALVIN DUBOSE
Title or Position: PRESIDENT
Credential: DMD
Phone: 404-987-3848