Provider Demographics
NPI:1558446740
Name:ROHM, JOHN G (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:ROHM
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 1:480 PENN LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:PA
Mailing Address - Zip Code:15126-9781
Mailing Address - Country:US
Mailing Address - Phone:724-695-2100
Mailing Address - Fax:724-695-8464
Practice Address - Street 1:480 PENN LINCOLN DR
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:PA
Practice Address - Zip Code:15126-9781
Practice Address - Country:US
Practice Address - Phone:724-695-2100
Practice Address - Fax:724-695-8464
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026537L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice