Individual
DR. JOSEPH JOHN KRUPA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3304 FOREST DR, COLUMBIA, SC 29204-4024
(803) 551-2572
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6496
NC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9256
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8995063
—
NC
05
—
ZX9256
—
SC
Enumeration date
11/15/2006
Last updated
05/05/2020
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