Provider Demographics
NPI:1477632875
Name:LAFLEUR, JOHN TODD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TODD
Last Name:LAFLEUR
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 1:13910 LYONS VALLEY RD
Mailing Address - Street 2:SUITE T
Mailing Address - City:JAMUL
Mailing Address - State:CA
Mailing Address - Zip Code:91935-2028
Mailing Address - Country:US
Mailing Address - Phone:619-669-1212
Mailing Address - Fax:619-245-2488
Practice Address - Street 1:13910 LYONS VALLEY RD
Practice Address - Street 2:SUITE T
Practice Address - City:JAMUL
Practice Address - State:CA
Practice Address - Zip Code:91935-2028
Practice Address - Country:US
Practice Address - Phone:619-669-1212
Practice Address - Fax:619-245-2488
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice