Provider Demographics
NPI:1851557524
Name:JOSHUA WHITFORD, DDS, PC
Entity Type:Organization
Organization Name:JOSHUA WHITFORD, DDS, PC
Other - Org Name:SILVER LAKE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WHITFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-894-0258
Mailing Address - Street 1:901 W FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-7200
Mailing Address - Country:US
Mailing Address - Phone:816-322-2292
Mailing Address - Fax:636-600-5314
Practice Address - Street 1:901 W FOXWOOD DR
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-7200
Practice Address - Country:US
Practice Address - Phone:816-322-2292
Practice Address - Fax:636-600-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty