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General NPI Number Information
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NPI Number | 1134515323
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Entity Type | Organization
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Legal Business Name | JOSEPH DENTAL OF WHEELERSBURG LLC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 8714 TENNYSON AVE
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City | WHEELERSBURG
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State | OH
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Zip | 45694-1932
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Country | US
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Telephone | 740-574-8044
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Fax |
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Provider Business Mailing Address
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Address Line | 8714 TENNYSON AVE
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City | WHEELERSBURG
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State | OH
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Zip | 45694-1932
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOE ROBERT JOSEPH JR.
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Credential | DDS
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Telephone | 614-777-9884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19829
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License Number State | OH
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