Provider Demographics
NPI:1396810347
Name:DEMICHELE, JOSHUA L (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:L
Last Name:DEMICHELE
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:NIAGARA QUALITYCARE DENTISTRY
Mailing Address - Street 2:8875 PORTER ROAD
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304
Mailing Address - Country:US
Mailing Address - Phone:716-297-5500
Mailing Address - Fax:716-297-5559
Practice Address - Street 1:NIAGARA QUALITYCARE DENTISTRY
Practice Address - Street 2:8875 PORTER ROAD
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304
Practice Address - Country:US
Practice Address - Phone:716-297-5500
Practice Address - Fax:726-297-5559
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050971 11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice