Provider Demographics
NPI:1265651376
Name:COLE, JOSEPH CHRISTIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHRISTIAN
Last Name:COLE
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 1:103 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15853-1701
Mailing Address - Country:US
Mailing Address - Phone:814-773-7674
Mailing Address - Fax:814-772-5718
Practice Address - Street 1:103 CENTER ST
Practice Address - Street 2:
Practice Address - City:RIDGWAY
Practice Address - State:PA
Practice Address - Zip Code:15853-1701
Practice Address - Country:US
Practice Address - Phone:814-773-7674
Practice Address - Fax:814-772-5718
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021580L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics