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Individual

DR. JOSEPH WILLIAM IVORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912
(706) 721-8623
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
(706) 721-3813

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DDS08292
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DDS08292
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DNF000430
GA

Other

Enumeration date
01/10/2006
Last updated
12/06/2019
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