Provider Demographics
NPI:1063940781
Name:KING, JOSEPH W (DDS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:W
Last Name:KING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-1561
Mailing Address - Country:US
Mailing Address - Phone:812-473-1128
Mailing Address - Fax:812-473-3850
Practice Address - Street 1:2038 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-1561
Practice Address - Country:US
Practice Address - Phone:812-473-1128
Practice Address - Fax:812-473-3850
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012700A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist