Provider Demographics
NPI:1225558240
Name:POGUE, JOSHUA T (DMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:T
Last Name:POGUE
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 1:3878 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-5326
Mailing Address - Country:US
Mailing Address - Phone:563-332-7734
Mailing Address - Fax:563-332-1649
Practice Address - Street 1:3878 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-5326
Practice Address - Country:US
Practice Address - Phone:563-332-7734
Practice Address - Fax:563-332-1649
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA094841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice