Provider Demographics
NPI:1922174440
Name:PRICE, JOEL ZENAN JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ZENAN
Last Name:PRICE
Suffix:JR
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 1:565 CORLEY MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072
Mailing Address - Country:US
Mailing Address - Phone:803-520-4900
Mailing Address - Fax:803-520-4890
Practice Address - Street 1:565 CORLEY MILL ROAD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072
Practice Address - Country:US
Practice Address - Phone:803-520-4900
Practice Address - Fax:803-520-4890
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC38001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2X3800Medicaid