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General NPI Number Information
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NPI Number | 1174339394
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Entity Type | Organization
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Legal Business Name | FREDERICK M JOUBERT DDS PLLC
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 3135 SPRINGBANK LN STE 210
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City | CHARLOTTE
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State | NC
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Zip | 28226-3361
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Country | US
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Telephone | 704-554-9199
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Fax | 704-543-7343
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Provider Business Mailing Address
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Address Line | 3135 SPRINGBANK LN STE 210
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City | CHARLOTTE
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State | NC
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Zip | 28226-3361
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Country | US
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Telephone | 704-544-9199
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Fax | 704-543-7343
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Authorized Official
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Title or Position | OWNER
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Name | DR. FREDERICK MICHAEL JOUBERT
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Credential | DDS
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Telephone | 704-544-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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