Provider Demographics
NPI:1679066005
Name:CAMBRIDGE, JOSHUA M (DMD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:M
Last Name:CAMBRIDGE
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 1:223 HARVEY TRL
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6792
Mailing Address - Country:US
Mailing Address - Phone:512-354-5913
Mailing Address - Fax:
Practice Address - Street 1:101 E HIGH ST
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2644
Practice Address - Country:US
Practice Address - Phone:903-455-1477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice