Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | G041331 | CA |
NPI | 1124132543 |
---|---|
Provider Name | Dr. John J Dann |
First Address | Lafayette, CA 94549-5094 |
Second Address | Lafayette, CA 94549-5094 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 16/01/2008 |