Provider Demographics
NPI:1316558307
Name:JOSHUA S. PRATHER DDS, LLC
Entity Type:Organization
Organization Name:JOSHUA S. PRATHER DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRATHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:573-289-0666
Mailing Address - Street 1:5810 MORNING STAR CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-1501
Mailing Address - Country:US
Mailing Address - Phone:573-289-0666
Mailing Address - Fax:
Practice Address - Street 1:214 E 2ND ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-1650
Practice Address - Country:US
Practice Address - Phone:573-289-0666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty