Provider Demographics
NPI:1457607434
Name:ROCKWOOD, JOSHUA LLOYD (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:LLOYD
Last Name:ROCKWOOD
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:DENTAL CLINIC 3
Mailing Address - Street 2:2954 CARRINGTON RD
Mailing Address - City:FORT BLISS
Mailing Address - State:TX
Mailing Address - Zip Code:79928
Mailing Address - Country:US
Mailing Address - Phone:915-742-2685
Mailing Address - Fax:
Practice Address - Street 1:DENTAL CLINIC 3
Practice Address - Street 2:2954 CARRINGTON RD
Practice Address - City:FORT BLISS
Practice Address - State:TX
Practice Address - Zip Code:79928
Practice Address - Country:US
Practice Address - Phone:915-742-2685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023702122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist