Provider Demographics
NPI:1356466346
Name:GARNER, JOHN VERNON (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:VERNON
Last Name:GARNER
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 1:102 NORTH GRACE
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:TX
Mailing Address - Zip Code:75835
Mailing Address - Country:US
Mailing Address - Phone:936-544-8884
Mailing Address - Fax:
Practice Address - Street 1:102 NORTH GRACE
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835
Practice Address - Country:US
Practice Address - Phone:936-544-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist