Provider Demographics
NPI:1255528378
Name:GORMAN, JOSHUA C (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:C
Last Name:GORMAN
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 1:9318 LOUETTA RD STE 500
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6547
Mailing Address - Country:US
Mailing Address - Phone:281-655-0063
Mailing Address - Fax:
Practice Address - Street 1:9318 LOUETTA RD STE 500
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6547
Practice Address - Country:US
Practice Address - Phone:281-655-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209661223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics