Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | D13976 | MN |
NPI | 1255837720 |
---|---|
Provider Name | Dr. Joseph Robert Sem |
First Address | Nome, AK 99762-0966 |
Second Address | Nome, AK 99762-9976 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2018 |
Last Update Date | 07/10/2019 |