Provider Demographics
NPI:1023301256
Name:WINWARD, JOSEPH R (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:WINWARD
Suffix:
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 1:415 TANNER ST
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-5418
Mailing Address - Country:US
Mailing Address - Phone:702-538-2213
Mailing Address - Fax:
Practice Address - Street 1:822 TURF FARM RD
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-5709
Practice Address - Country:US
Practice Address - Phone:801-465-4490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7996314-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist