Doctor Name: | DR. JOHN DAVID LANDGREN |
NPI Number: | 1427260744 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S. |
License Number: | 6546 |
Business Practice Address: | 483 W. Seed Farm Rd. Sacaton, AZ - 851470038 |
Business Phone Number: | 6025281200 |
Business Fax Number: | 6025281255 |
Mailing Address: | P.o. Box 38, SACATON |
State: | AZ |
Postal Code: | 851470038 |
Phone Number: | 6025281200 |
Fax Number: | 6025281255 |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 12/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 6546 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
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. |