Provider Demographics
NPI:1902994403
Name:GUMS, JOSEPH HAROLD (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HAROLD
Last Name:GUMS
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 1:301 S HAM LN STE B
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-3547
Mailing Address - Country:US
Mailing Address - Phone:209-333-8537
Mailing Address - Fax:209-333-0417
Practice Address - Street 1:301 S HAM LN STE B
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-3547
Practice Address - Country:US
Practice Address - Phone:209-333-8537
Practice Address - Fax:209-333-0417
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0347081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice