Provider Demographics
NPI:1407042047
Name:HART, JOHN FRANCIS JR (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:HART
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 1:7350 COLLEGE DR
Mailing Address - Street 2:STE 203
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1190
Mailing Address - Country:US
Mailing Address - Phone:708-361-3440
Mailing Address - Fax:708-361-6779
Practice Address - Street 1:7350 COLLEGE DR
Practice Address - Street 2:STE 203
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1190
Practice Address - Country:US
Practice Address - Phone:708-361-3440
Practice Address - Fax:708-361-6779
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19014865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist