Provider Demographics
NPI:1699035311
Name:RICH, JOSIAH MERTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSIAH
Middle Name:MERTON
Last Name:RICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8128 RENAISSANCE PKWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6695
Mailing Address - Country:US
Mailing Address - Phone:919-493-3355
Mailing Address - Fax:
Practice Address - Street 1:8128 RENAISSANCE PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6695
Practice Address - Country:US
Practice Address - Phone:919-493-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice