Individual
DR. JOE ALLAN PROVINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
105 SOUTH DR, SUITE 200, MOUNTAIN VIEW, CA 94040-4311
(650) 964-4867
(650) 964-4864
Mailing address
877 W FREMONT AVE, STE I2, SUNNYVALE, CA 94087-2319
(650) 964-4867
(650) 964-4864
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
20440
CA
Other
Enumeration date
10/13/2006
Last updated
04/04/2016
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