Provider Demographics
NPI:1285971549
Name:KING, JOSEPH MAURICE (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MAURICE
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 1:427 S GOLDEN GATE AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95205-6646
Mailing Address - Country:US
Mailing Address - Phone:415-424-6406
Mailing Address - Fax:
Practice Address - Street 1:9130 ALCOSTA BLVD STE A
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-3847
Practice Address - Country:US
Practice Address - Phone:925-803-9700
Practice Address - Fax:925-803-2568
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62119122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist