Provider Information for 1154761013
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Dr. JOSHUA KIRK DMD
Sex: Male
NPI: 1154761013
Last Updated: 2015-07-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1154761013 | ||||||||||||
| Enumeration Date | 2013-06-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 407 N CONWAY ST KENNEWICK, WA 99336-3047 United States Phone: 509-783-4194 | Fax: | ||||||||||||
| Primary Practice Address | 407 N CONWAY ST KENNEWICK, WA 99336-3047 United States Phone: 509-783-4194 | Fax: | ||||||||||||
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