Provider Demographics
NPI:1255411922
Name:ALBERTINE, JOSEPH A (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:ALBERTINE
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 1:239 MUIR AVE.
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201
Mailing Address - Country:US
Mailing Address - Phone:570-455-4858
Mailing Address - Fax:
Practice Address - Street 1:239 MUIR AVE
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-7328
Practice Address - Country:US
Practice Address - Phone:570-455-4858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA023040-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist