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General NPI Number Information
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NPI Number | 1487376927
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Entity Type | Individual
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Provider Name | JOSEPH ANDREW VAUGHN DDS
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Gender | Male
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 1716 W 11TH ST
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City | SEDALIA
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State | MO
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Zip | 65301-5221
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Country | US
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Telephone | 660-530-0209
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Fax |
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Provider Business Mailing Address
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Address Line | 3520 ASHLAND LN
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City | SEDALIA
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State | MO
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Zip | 65301-2481
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Country | US
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Telephone | 361-935-5575
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2021048141
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License Number State | MO
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