Joe, Stephen W.

Joe, Stephen W. is an individual health care provider with primary practice located at 4824 Goodman Road , Olive Branch MS 38654. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Joe, Stephen W. can be contacted via phone (662) 874-5917.

Contact Information

Primary practice address
4824 Goodman Road Olive Branch MS 38654
Phone: (662) 874-5917
Fax: (662) 874-5998
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2019-83 Mississippi

Profile Details

NPI number 1609896729
LBN Legal business name Joe, Stephen W.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Sep 14th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609896729 NPPES
Mississippi MEDICAID 00060134

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