Provider Demographics
NPI:1962817304
Name:MANSFIELD, JOSH (DDS)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:MANSFIELD
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 1:809 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-3744
Mailing Address - Country:US
Mailing Address - Phone:501-982-4444
Mailing Address - Fax:501-982-6616
Practice Address - Street 1:809 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3744
Practice Address - Country:US
Practice Address - Phone:501-982-4444
Practice Address - Fax:501-982-6616
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3987122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist