Provider Demographics
NPI:1891831392
Name:QURESHI, JOAN VIANTHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:VIANTHA
Last Name:QURESHI
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:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:SHERBORN
Mailing Address - State:MA
Mailing Address - Zip Code:01770
Mailing Address - Country:US
Mailing Address - Phone:508-653-6064
Mailing Address - Fax:
Practice Address - Street 1:20 NORTH MAIN ST
Practice Address - Street 2:SUITE 160
Practice Address - City:SHERBORN
Practice Address - State:MA
Practice Address - Zip Code:01770
Practice Address - Country:US
Practice Address - Phone:508-653-6064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA162001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice