Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 3117 | SC |
NPI | 1003881962 |
---|---|
Provider Name | Dr. Paul Thomas Joseph JR. |
First Address | Camden, SC 29020 |
Second Address | Camden, SC 29020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 08/01/2016 |