Provider Demographics
NPI:1104001437
Name:KLOPFER, JOHN WILLIAM JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:KLOPFER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HARRISBURG ST
Mailing Address - Street 2:P.O.BOX 648
Mailing Address - City:EAST BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17316-8815
Mailing Address - Country:US
Mailing Address - Phone:717-259-9612
Mailing Address - Fax:717-259-0534
Practice Address - Street 1:113 HARRISBURG ST
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17316-8815
Practice Address - Country:US
Practice Address - Phone:717-259-9612
Practice Address - Fax:717-259-0534
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-06
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021955L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice