Provider Demographics
NPI:1447852587
Name:JOSHUA A DUBOSE DMD, PC
Entity type:Organization
Organization Name:JOSHUA A DUBOSE DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:DUBOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-987-3848
Mailing Address - Street 1:501 E MARTINTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-5303
Mailing Address - Country:US
Mailing Address - Phone:803-279-4343
Mailing Address - Fax:803-279-4378
Practice Address - Street 1:501 E MARTINTOWN RD
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-5303
Practice Address - Country:US
Practice Address - Phone:803-279-4343
Practice Address - Fax:803-279-4378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty