Provider Demographics
NPI:1417190919
Name:WAFF, JOSEPH JUDSON III (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JUDSON
Last Name:WAFF
Suffix:III
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 1:2202 N BERKSHIRE RD
Mailing Address - Street 2:103
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2761
Mailing Address - Country:US
Mailing Address - Phone:434-293-9916
Mailing Address - Fax:434-293-3879
Practice Address - Street 1:2202 N BERKSHIRE RD
Practice Address - Street 2:103
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2761
Practice Address - Country:US
Practice Address - Phone:434-293-9916
Practice Address - Fax:434-293-3879
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401003556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist