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NPI Code Detail

MEDICARE: JOSHUA COUSSA DMD, PA

MEDICARE: JOSHUA COUSSA DMD, PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist17589FL

General Provider Information

NPI Number : 1588037949
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSHUA COUSSA DMD, PA
Provider Business Mailing Address
First Line : 2171 NE 28TH ST
Second Line :
City : LIGHTHOUSE POINT
State : FL
Zip : 33064-7616
Country : US
Telephone Number : 954-290-4340
Fax Number :
Provider Business Practice Location Address
First Line : 8235 W ATLANTIC BLVD
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-7450
Country : US
Telephone Number : 954-753-6100
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSHUA JON COUSSA
Credential : D.M.D.
Telephone Number : 954-290-4340
Provider Enumeration Date : 11/07/2015
Last Update Date : 03/18/2016

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Directions to “JOSHUA COUSSA DMD, PA ” Practice Location

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