Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DEN1000266 | DC |
NPI | 1003916958 |
---|---|
Provider Name | Dr. George Titus Joncas |
First Address | Washington, DC 20016 |
Second Address | Washington, DC 20016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 08/07/2007 |