Provider Demographics
NPI:1023003050
Name:JOSEPH, STEPHEN M (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1654 S SMITHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45410-3247
Mailing Address - Country:US
Mailing Address - Phone:937-252-8551
Mailing Address - Fax:937-252-4311
Practice Address - Street 1:1654 S SMITHVILLE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-3247
Practice Address - Country:US
Practice Address - Phone:937-252-8551
Practice Address - Fax:937-252-4311
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice