Provider Demographics
NPI:1508041328
Name:JOSEPH E. FURTADO, DDS.INC
Entity Type:Organization
Organization Name:JOSEPH E. FURTADO, DDS.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:FURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-654-1008
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:OK
Mailing Address - Zip Code:73015-0156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:580-654-2008
Practice Address - Street 1:6 N BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:OK
Practice Address - Zip Code:73015
Practice Address - Country:US
Practice Address - Phone:580-654-1008
Practice Address - Fax:580-654-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK29671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty