Provider Demographics
NPI:1326228248
Name:JOSEPH, DANNY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANNY
Middle Name:
Last Name:JOSEPH
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 1:375 EAST MAIN ST
Mailing Address - Street 2:SUITE 18 MEDICAL ARTS BLDG
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706
Mailing Address - Country:US
Mailing Address - Phone:631-968-0302
Mailing Address - Fax:631-968-0302
Practice Address - Street 1:375 EAST MAIN ST
Practice Address - Street 2:SUITE 18 MEDICAL ARTS BLDG
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-968-0302
Practice Address - Fax:631-968-0302
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042041223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics