Provider Demographics
NPI:1205812815
Name:ALBERT, JOSEPH MATHEW (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MATHEW
Last Name:ALBERT
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 1:22315 HWY 99 N
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026
Mailing Address - Country:US
Mailing Address - Phone:425-771-3266
Mailing Address - Fax:425-774-7917
Practice Address - Street 1:22315 HWY 99 N
Practice Address - Street 2:SUITE 1
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026
Practice Address - Country:US
Practice Address - Phone:425-771-3266
Practice Address - Fax:425-774-7917
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist