Provider Demographics
NPI:1396274031
Name:GEORGE, JOSHUA K (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:K
Last Name:GEORGE
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 1:400 N LOOP 1604 E STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1246
Mailing Address - Country:US
Mailing Address - Phone:502-709-3847
Mailing Address - Fax:
Practice Address - Street 1:400 N LOOP 1604 E STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1246
Practice Address - Country:US
Practice Address - Phone:502-709-3847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204580122300000X
TN10548122300000X
KY9933122300000X
TX36771122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist