Provider Demographics
NPI:1407154370
Name:DOLIN, JOSHUA MARC
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MARC
Last Name:DOLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5413
Mailing Address - Country:US
Mailing Address - Phone:304-292-7307
Mailing Address - Fax:304-292-1154
Practice Address - Street 1:142 HIGH STREET
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5413
Practice Address - Country:US
Practice Address - Phone:304-292-7307
Practice Address - Fax:304-292-1154
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV3665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist