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General NPI Number Information
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NPI Number | 1962692988
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Entity Type | Organization
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Legal Business Name | WAYNE J JOSEPH, D.D.S.,MS,PC
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 10751 WHITTIER ST
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City | DETROIT
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State | MI
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Zip | 48224-1754
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Country | US
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Telephone | 313-521-5800
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Fax | 734-721-4746
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Provider Business Mailing Address
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Address Line | 10751 WHITTIER ST 19010 W TEN MILE RD
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City | DETROIT
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State | MI
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Zip | 48224-1754
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Country | US
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Telephone | 313-521-5800
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Fax | 734-721-4746
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Authorized Official
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Title or Position | DR.
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Name | DR. WAYNE J JOSEPH
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Credential | D.D.S.
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Telephone | 313-521-5800
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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 | 12348
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License Number State | MI
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