Provider Demographics
NPI:1487823811
Name:JOSEPH E. JAMISON, DDS, P. A.
Entity Type:Organization
Organization Name:JOSEPH E. JAMISON, DDS, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ENNEIS
Authorized Official - Last Name:JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-763-2185
Mailing Address - Street 1:1409 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7504
Mailing Address - Country:US
Mailing Address - Phone:910-763-2185
Mailing Address - Fax:910-763-0429
Practice Address - Street 1:1409 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7504
Practice Address - Country:US
Practice Address - Phone:910-763-2185
Practice Address - Fax:910-763-0429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC43611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty