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Individual

JOSEPH HUMPHRIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1128 WABASH AVE, TERRE HAUTE, IN 47807-3212
(203) 530-3136
Mailing address
6918 SAMUEL LONG WAY, LOUISVILLE, KY 40229-2303

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
10993
KY
122300000X
Dentist
Primary
12014868A
IN
1223G0001X
General Practice Dentistry
019.034891
IL
1223G0001X
General Practice Dentistry
12645
TN
1223G0001X
General Practice Dentistry
2025017068
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/12/2023
Last updated
09/23/2025
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