Provider Demographics
NPI:1417060633
Name:OSTERKAMP, JOHN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:OSTERKAMP
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 1:709 FAIR AVE
Mailing Address - Street 2:
Mailing Address - City:BUHE
Mailing Address - State:ID
Mailing Address - Zip Code:83316
Mailing Address - Country:US
Mailing Address - Phone:208-543-8907
Mailing Address - Fax:208-543-6190
Practice Address - Street 1:709 FAIR ST
Practice Address - Street 2:
Practice Address - City:BUHL
Practice Address - State:ID
Practice Address - Zip Code:83316-6442
Practice Address - Country:US
Practice Address - Phone:208-543-8907
Practice Address - Fax:208-543-6190
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD3004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist