Provider Demographics
NPI:1487664462
Name:DOERR, JOHN DAVIDSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVIDSON
Last Name:DOERR
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 1:5255 E KNIGHT DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2147
Mailing Address - Country:US
Mailing Address - Phone:520-881-6767
Mailing Address - Fax:520-881-3759
Practice Address - Street 1:5255 E KNIGHT DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2147
Practice Address - Country:US
Practice Address - Phone:520-881-6767
Practice Address - Fax:520-881-3759
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice