Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 12008724A | IN |
NPI | 1063629871 |
---|---|
Provider Name | Dr. John Gregory Rapp |
First Address | Carmel, IN 46032-2916 |
Second Address | Carmel, IN 46032-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |