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General NPI Number Information
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NPI Number | 1568642924
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Entity Type | Organization
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Legal Business Name | DAVID B JOSEPH A PROFESSIONAL DENTAL CORP
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 1183 E MAIN ST SUITE G
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City | EL CAJON
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State | CA
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Zip | 92021
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Country | US
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Telephone | 619-441-2566
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Fax | 619-441-2554
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Provider Business Mailing Address
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Address Line | 1183 E MAIN ST SUITE G
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City | EL CAJON
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State | CA
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Zip | 92021
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Country | US
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Telephone | 619-441-2566
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Fax | 619-441-2554
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Authorized Official
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Title or Position | DR PRESIDENT
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Name | DAVID BENJAMINE JOSEPH
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Credential | DDS
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Telephone | 619-441-2566
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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 | 53605
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License Number State | CA
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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 | 53605
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License Number State | CA
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