Provider Demographics
NPI:1497832208
Name:BIANCHI, JOHN JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:BIANCHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BISBEE STREET
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ME
Mailing Address - Zip Code:04250-6835
Mailing Address - Country:US
Mailing Address - Phone:207-353-8676
Mailing Address - Fax:207-353-6797
Practice Address - Street 1:4 BISBEE STREET
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ME
Practice Address - Zip Code:04250-6835
Practice Address - Country:US
Practice Address - Phone:207-353-8676
Practice Address - Fax:207-353-6797
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME32251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice