Provider Demographics
NPI:1275894099
Name:POSTON, JOHN SAMUEL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SAMUEL
Last Name:POSTON
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 1:111 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:MO
Mailing Address - Zip Code:64633-1624
Mailing Address - Country:US
Mailing Address - Phone:660-542-1117
Mailing Address - Fax:
Practice Address - Street 1:111 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:MO
Practice Address - Zip Code:64633-1624
Practice Address - Country:US
Practice Address - Phone:660-542-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012015452122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist