Provider Demographics
NPI:1316076672
Name:JOSEPH, DAVID BENJAMINE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BENJAMINE
Last Name:JOSEPH
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 1:1183 E MAIN ST STE G
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-7165
Mailing Address - Country:US
Mailing Address - Phone:619-441-2566
Mailing Address - Fax:619-441-2554
Practice Address - Street 1:1183 E MAIN ST STE G
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-7165
Practice Address - Country:US
Practice Address - Phone:619-441-2566
Practice Address - Fax:619-441-2554
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA536051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice