Doctor Name: | JOHN C PAGE |
NPI Number: | 1134285455 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S., M.S. |
License Number: | 4237 |
Business Practice Address: | 7734 Airways Blvd Southaven, MS - 386715306 |
Business Phone Number: | 6623493838 |
Business Fax Number: | 6623495923 |
Mailing Address: | 7734 Airways, SOUTHAVEN |
State: | MS |
Postal Code: | 38671 |
Phone Number: | 6623493838 |
Fax Number: | 6623495923 |
NPI Enumeration Date: | 12/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 4237 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
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. |