Provider Demographics
NPI:1780739656
Name:CAIN, JOSEPH J (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:CAIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 VARDAMAN ST S
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577-2600
Mailing Address - Country:US
Mailing Address - Phone:601-528-9834
Mailing Address - Fax:
Practice Address - Street 1:208 VARDAMAN ST S
Practice Address - Street 2:
Practice Address - City:WIGGINS
Practice Address - State:MS
Practice Address - Zip Code:39577-2600
Practice Address - Country:US
Practice Address - Phone:601-528-9834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS29901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice