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General NPI Number Information
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NPI Number | 1851915060
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Entity Type | Individual
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Provider Name | JOSHUA STEPHENS DDS
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Gender | Male
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 25 LONG CREEK DR STE 2
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2441
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Country | US
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Telephone | 207-775-2072
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Fax |
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Provider Business Mailing Address
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Address Line | 48 RANGE RD
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City | CUMBERLAND
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State | ME
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Zip | 04021-3438
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Country | US
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Telephone | 574-386-5311
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4789
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License Number State | ME
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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 | DEN4789
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License Number State | ME
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