Joseph Richard Deatherage in Bismarck - Oral And Maxillofacial Surgery
Joseph Richard Deatherage - NPI 1003859117
Joseph Richard Deatherage is a Oral And Maxillofacial Surgery in Bismarck, North Dakota. Joseph Richard Deatherage practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Joseph Richard Deatherage is 1003859117. The last update date is 2019-05-01.
Joseph Richard Deatherage's current location address is 1730 Burnt Boat Dr Ste 300, Bismarck, North Dakota. You can contact this provider via phone number 7012587220 and fax number 7012222329. The mailing address for Joseph Richard Deatherage is 1730 Burnt Boat Dr Ste 300, Bismarck, North Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Joseph Richard Deatherage |
|---|---|
| Address | 1730 Burnt Boat Dr Ste 300, Bismarck, North Dakota |
| Phone Number | 7012587220 |
| Fax Number | 7012222329 |
| Sole Proprietor | N |
| Credentials | DMD, MD |
NPI Number Detail
| NPI Number | 1003859117 |
|---|---|
| Provider Enumeration Date | 2006-06-14 |
| Last Updated Date | 2019-05-01 |
Provider Mailing Address Detail
| Address | 1730 Burnt Boat Dr Ste 300 |
|---|---|
| City | Bismarck |
| State | North Dakota (ND) |
| Post Code | 585030886 |
| Phone Number | 7012587220 |
| Fax Number | 7012222329 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 2069 |
|
Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2069 | ND | DENTAL LICENSE | |
| 41524 | ND | -- |
Post Comment/ Review Below
What is the Joseph Richard Deatherage's 1003859117?
The Joseph Richard Deatherage's NPI (National Provider Identifier) Number is 1003859117. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Joseph Richard Deatherage?
The Joseph Richard Deatherage is situated at 1730 Burnt Boat Dr Ste 300, in the city of Bismarck, state of ND, with the zip code 585030886.
What is Joseph Richard Deatherage's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Joseph Richard Deatherage's specialized field of practice is Oral And Maxillofacial Surgery, and the corresponding taxonomy code that categorizes this area of specialization is 1223S0112X.
On what date did the Joseph Richard Deatherage receive its 1003859117 assignment from the Centers for Medicare & Medicaid Services?
The Joseph Richard Deatherage was assigned its 1003859117 by the Centers for Medicare & Medicaid Services on 2006-06-14.
When was the information regarding Joseph Richard Deatherage most recently updated?
The details pertaining to the Joseph Richard Deatherage, including its address, specialty, and other relevant information, were last refreshed on 2019-05-01.