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General NPI Number Information
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NPI Number | 1346500170
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Entity Type | Individual
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Provider Name | JOSEPH MUSSELMAN DMD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2012
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 1277 E MISSOURI AVE STE 111
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City | PHOENIX
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State | AZ
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Zip | 85014-2916
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Country | US
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Telephone | 602-277-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 1277 E MISSOURI AVE STE 111
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City | PHOENIX
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State | AZ
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Zip | 85014-2916
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Country | US
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Telephone | 602-277-4464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS039084
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2013027107
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D009091
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License Number State | AZ
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