Provider Demographics
NPI:1821214412
Name:ALFORD, JOEL TERRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:TERRY
Last Name:ALFORD
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 1:6220 MANATEE AVE W
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-2376
Mailing Address - Country:US
Mailing Address - Phone:941-792-3033
Mailing Address - Fax:941-792-4010
Practice Address - Street 1:6220 MANATEE AVE W
Practice Address - Street 2:SUITE 401
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2376
Practice Address - Country:US
Practice Address - Phone:941-792-3033
Practice Address - Fax:941-792-4010
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL78831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice