Provider Demographics
NPI:1942320817
Name:JOSEPH AND JOSEPH DENTAL LLC
Entity Type:Organization
Organization Name:JOSEPH AND JOSEPH DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-893-5131
Mailing Address - Street 1:515 E MILL ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:WI
Mailing Address - Zip Code:53073-1824
Mailing Address - Country:US
Mailing Address - Phone:920-893-5131
Mailing Address - Fax:920-893-5914
Practice Address - Street 1:435 E MILL ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:WI
Practice Address - Zip Code:53073-1850
Practice Address - Country:US
Practice Address - Phone:920-893-5131
Practice Address - Fax:920-893-5914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty