Provider Demographics
NPI:1982363933
Name:JOSEPHS FAMILY DENTISTRY PLLC
Entity Type:Organization
Organization Name:JOSEPHS FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPHS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-732-1450
Mailing Address - Street 1:41 CROSSROADS LN APT 1205
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-3011
Mailing Address - Country:US
Mailing Address - Phone:646-305-2709
Mailing Address - Fax:
Practice Address - Street 1:3380 S DYE RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1008
Practice Address - Country:US
Practice Address - Phone:810-732-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental