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General NPI Number Information
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NPI Number | 1720391402
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Entity Type | Organization
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Legal Business Name | JOSHUA A. DUBOSE, D.M.D., P.C.
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 416 E SPRING ST
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City | MONROE
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State | GA
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Zip | 30655-2350
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Country | US
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Telephone | 770-267-6822
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Fax | 770-267-0928
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Provider Business Mailing Address
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Address Line | PO BOX 1214
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City | MONROE
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State | GA
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Zip | 30655-1214
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Country | US
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Telephone | 770-267-6822
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Fax | 770-267-0928
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Authorized Official
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Title or Position | CEO
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Name | DR. JOSHUA A. DUBOSE
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Credential | D.M.D.
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Telephone | 770-267-6822
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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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