Provider Demographics
NPI:1417071705
Name:CZAP, JOHN P (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:CZAP
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 1:701 HASTINGS STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17702
Mailing Address - Country:US
Mailing Address - Phone:570-323-7113
Mailing Address - Fax:570-323-7106
Practice Address - Street 1:701 HASTINGS STREET
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17702
Practice Address - Country:US
Practice Address - Phone:570-323-7113
Practice Address - Fax:570-323-7106
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS 027524 L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice