Provider Demographics
NPI:1023547536
Name:RICE, JOSHUA MORGAN (DDS)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:MORGAN
Last Name:RICE
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 1:209 CRATER LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7020
Mailing Address - Country:US
Mailing Address - Phone:541-779-6401
Mailing Address - Fax:641-608-6814
Practice Address - Street 1:209 CRATER LAKE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7020
Practice Address - Country:US
Practice Address - Phone:541-779-6401
Practice Address - Fax:641-608-6814
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-48431223G0001X
ORD107971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice