Provider Demographics
NPI:1073739082
Name:ROSS, JOEL (DMD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 LITTLETON RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-3536
Mailing Address - Country:US
Mailing Address - Phone:978-692-3377
Mailing Address - Fax:978-392-0056
Practice Address - Street 1:288 LITTLETON RD
Practice Address - Street 2:SUITE 9
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3536
Practice Address - Country:US
Practice Address - Phone:978-692-3377
Practice Address - Fax:978-392-0056
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA117671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice