Provider Demographics
NPI:1275656753
Name:DAMAS, JOHN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:DAMAS
Suffix:
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 1:15100 S LA GRANGE RD
Mailing Address - Street 2:SUITE # 202
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3751
Mailing Address - Country:US
Mailing Address - Phone:708-349-1740
Mailing Address - Fax:708-349-1927
Practice Address - Street 1:15100 S LA GRANGE RD
Practice Address - Street 2:SUITE # 202
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3751
Practice Address - Country:US
Practice Address - Phone:708-349-1740
Practice Address - Fax:708-349-1927
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILS8471223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics