Provider Demographics
NPI:1568096154
Name:DENT, JOEL MICHAEL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:MICHAEL
Last Name:DENT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 LAPORTE ST SE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-6242
Mailing Address - Country:US
Mailing Address - Phone:706-340-5769
Mailing Address - Fax:
Practice Address - Street 1:1476 TURNER MCCALL BLVD SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-6072
Practice Address - Country:US
Practice Address - Phone:706-290-8043
Practice Address - Fax:706-290-9731
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0226701835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist