Doctor Name: | DR. JOHN DOUGLAS PAGE |
NPI Number: | 1043433758 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DMD |
License Number: | 7984 |
Business Practice Address: | 204 W Paige Street Tompkinsville, KY - 42167 |
Business Phone Number: | 2704875196 |
Business Fax Number: | 2704875196 |
Mailing Address: | 204 W Paige Street, Po Box 249 TOMPKINSVILLE |
State: | KY |
Postal Code: | 42167 |
Phone Number: | 2704875196 |
Fax Number: | 2704875196 |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 05/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 7984 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |