Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 2022 | WV |
NPI | 1265538870 |
---|---|
Provider Name | Dr. John T Pappas |
First Address | Wheeling, WV 26003-1626 |
Second Address | Wheeling, WV 26003-5300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/07/2007 |