Individual
DR. JOACHIM M PROVENZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
984 BRASS CASTLE RD, BELVIDERE, NJ 07823-2752
(908) 475-3641
Mailing address
30 WOLF HILL DR, WARREN, NJ 07059-5327
(908) 580-0075
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI01812900
NJ
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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