Provider Demographics
NPI:1306418546
Name:DWOREK, JOSEPH J (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:DWOREK
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 1:517 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-5761
Mailing Address - Country:US
Mailing Address - Phone:412-805-9154
Mailing Address - Fax:
Practice Address - Street 1:3420 PLEASANT VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4338
Practice Address - Country:US
Practice Address - Phone:814-943-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0432831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice