Provider Demographics
NPI:1780767871
Name:JOSHUA E. CADWELL DDS PLLC
Entity type:Organization
Organization Name:JOSHUA E. CADWELL DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:TOROK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-627-6888
Mailing Address - Street 1:475 KEENE RD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-5007
Mailing Address - Country:US
Mailing Address - Phone:509-627-6888
Mailing Address - Fax:509-627-6720
Practice Address - Street 1:475 KEENE RD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-5007
Practice Address - Country:US
Practice Address - Phone:509-627-6888
Practice Address - Fax:509-627-6720
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSHUA E CADWELL DDS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA100241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6415320001Medicare NSC