Provider Demographics
NPI:1891922167
Name:TESENE, JOSEPH PATRICK (DDS)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:TESENE
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 1:1008 W PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50225-9546
Mailing Address - Country:US
Mailing Address - Phone:515-848-3691
Mailing Address - Fax:515-848-3692
Practice Address - Street 1:1008 W PLEASANT ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:IA
Practice Address - Zip Code:50225-9546
Practice Address - Country:US
Practice Address - Phone:515-848-3691
Practice Address - Fax:515-848-3692
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice