Provider Demographics
NPI:1689953911
Name:DAVIDSON, JOSHUA E (DMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:E
Last Name:DAVIDSON
Suffix:
Gender:M
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:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-0580
Mailing Address - Country:US
Mailing Address - Phone:559-386-4500
Mailing Address - Fax:559-282-5080
Practice Address - Street 1:781 SEQUOIA AVE STE 4
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-1448
Practice Address - Country:US
Practice Address - Phone:559-562-9400
Practice Address - Fax:559-562-1300
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice