Provider Demographics
NPI:1992928246
Name:FORSMAN, JOE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:
Last Name:FORSMAN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 QUAKER AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-5143
Mailing Address - Country:US
Mailing Address - Phone:806-795-6415
Mailing Address - Fax:806-795-9123
Practice Address - Street 1:6400 QUAKER AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5143
Practice Address - Country:US
Practice Address - Phone:806-795-6415
Practice Address - Fax:806-795-9123
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE-08772-61223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics