Provider Demographics
NPI:1578608543
Name:WATESKA, JOSEPH ANTHONY (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:WATESKA
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:454 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9569
Mailing Address - Country:US
Mailing Address - Phone:724-746-1440
Mailing Address - Fax:724-746-7110
Practice Address - Street 1:501 CORPORATE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-8584
Practice Address - Country:US
Practice Address - Phone:724-746-1440
Practice Address - Fax:724-746-7110
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029903L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics