Provider Demographics
NPI:1376559211
Name:GRIFFITH, JOHN SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SCOTT
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MEADOW GREEN DR
Mailing Address - Street 2:
Mailing Address - City:MIFFLINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17844-9305
Mailing Address - Country:US
Mailing Address - Phone:570-966-9757
Mailing Address - Fax:570-966-9756
Practice Address - Street 1:201 MEADOW GREEN DR
Practice Address - Street 2:
Practice Address - City:MIFFLINBURG
Practice Address - State:PA
Practice Address - Zip Code:17844-9305
Practice Address - Country:US
Practice Address - Phone:570-966-9757
Practice Address - Fax:570-966-9756
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030536L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice