Provider Demographics
NPI:1639662778
Name:JOSEPH, SONYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 TREMONT ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3179
Mailing Address - Country:US
Mailing Address - Phone:260-402-7446
Mailing Address - Fax:
Practice Address - Street 1:77 HURLEY ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-2134
Practice Address - Country:US
Practice Address - Phone:260-402-7446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18579621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice