Provider Demographics
NPI:1245447812
Name:FAVOR, JOSEPH EVERETTE (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EVERETTE
Last Name:FAVOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11102 BRIAR FOREST DR.
Mailing Address - Street 2:SUITE E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042
Mailing Address - Country:US
Mailing Address - Phone:713-784-8404
Mailing Address - Fax:713-781-1399
Practice Address - Street 1:11102 BRIAR FOREST DR
Practice Address - Street 2:SUITE E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042
Practice Address - Country:US
Practice Address - Phone:713-784-8404
Practice Address - Fax:713-781-1399
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist