Provider Demographics
NPI:1134239460
Name:GARNER, JOE NEIL (DMD)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:NEIL
Last Name:GARNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:N
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD PC
Mailing Address - Street 1:288 REDFERN VILLAGE
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522
Mailing Address - Country:US
Mailing Address - Phone:912-638-9090
Mailing Address - Fax:912-638-0990
Practice Address - Street 1:288 REDFERN VILLAGE
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522
Practice Address - Country:US
Practice Address - Phone:912-638-9090
Practice Address - Fax:912-638-0990
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7564122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist