Individual
DR. JOSEPH BAISDEN MICKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2912 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4010
(336) 765-8941
(336) 765-1473
Mailing address
4814 SIX FORKS RD, RALEIGH, NC 27609-5246
(919) 783-5550
(919) 791-1990
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3378
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8995944
—
NC
Enumeration date
05/03/2007
Last updated
07/08/2007
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