Individual
DR. JOSEPH W PROVO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1460 IH 10 EAST, SUITE A, BEAUMONT, TX 77703
(409) 833-0261
(409) 833-0543
Mailing address
1460 IH 10 EAST, SUITE A, BEAUMONT, TX 77703
(409) 833-0261
(409) 833-0543
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16452
TX
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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