Provider Demographics
NPI:1386862779
Name:FORCHE, JOHN ROBERT (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERT
Last Name:FORCHE
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 1:7241 SAINT THOMAS CT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-2244
Mailing Address - Country:US
Mailing Address - Phone:419-843-9121
Mailing Address - Fax:
Practice Address - Street 1:3409 WINSTON BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3855
Practice Address - Country:US
Practice Address - Phone:419-382-0357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18966122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist