Provider Demographics
NPI:1386637494
Name:COWART, JOSHUA KEITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:KEITH
Last Name:COWART
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 1:25052 104TH AVE SE
Mailing Address - Street 2:SUITE C
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6853
Mailing Address - Country:US
Mailing Address - Phone:253-852-9055
Mailing Address - Fax:
Practice Address - Street 1:25052 104TH AVE SE
Practice Address - Street 2:SUITE C
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-6853
Practice Address - Country:US
Practice Address - Phone:253-852-9055
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA85311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice