Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN012761 | GA |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN012761 | GA |
N | 204E00000X | Oral & Maxillofacial Surgeon | DN012761 | GA |
NPI | 1093927048 |
---|---|
Provider Name | Dr. John C. Pritchett |
First Address | Andrews Afb, MD 20762-6601 |
Second Address | Andrews Afb, MD 20762-6601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 29/12/2011 |