Provider Demographics
NPI:1750649430
Name:ETMAN, JOSHUA DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAVID
Last Name:ETMAN
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 1:8235 LAWSON BRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-0019
Mailing Address - Country:US
Mailing Address - Phone:561-338-6411
Mailing Address - Fax:
Practice Address - Street 1:7015 BERACASA WAY STE 101
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3453
Practice Address - Country:US
Practice Address - Phone:561-338-6411
Practice Address - Fax:561-368-9949
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV65471223G0001X
FL259901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice