Provider Demographics
NPI:1841293644
Name:BROOKS, JOEL M (DDS)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:M
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21 CORPORATE DR
Mailing Address - Street 2:STE 5
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2664
Mailing Address - Country:US
Mailing Address - Phone:610-253-6197
Mailing Address - Fax:610-515-0792
Practice Address - Street 1:21 CORPORATE DR
Practice Address - Street 2:STE 5
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-2664
Practice Address - Country:US
Practice Address - Phone:610-253-6197
Practice Address - Fax:610-515-0792
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS0205501223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics