Provider Demographics
NPI:1366531378
Name:LITCH, JOYCE M (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:M
Last Name:LITCH
Suffix:
Gender:F
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 S BASCOM AVE
Mailing Address - Street 2:1
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-3297
Mailing Address - Country:US
Mailing Address - Phone:408-371-7616
Mailing Address - Fax:408-371-7651
Practice Address - Street 1:2160 S BASCOM AVE
Practice Address - Street 2:#1
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-3294
Practice Address - Country:US
Practice Address - Phone:408-371-7616
Practice Address - Fax:408-371-7651
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347321223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics