Provider Demographics
NPI:1568572238
Name:CARMICHAEL, JOHN R (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:CARMICHAEL
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:2281 PYRAMID WAY
Mailing Address - Street 2:#11
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431
Mailing Address - Country:US
Mailing Address - Phone:775-355-0404
Mailing Address - Fax:775-355-0439
Practice Address - Street 1:2281 PYRAMID WAY
Practice Address - Street 2:#11
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431
Practice Address - Country:US
Practice Address - Phone:775-355-0404
Practice Address - Fax:775-355-0439
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS7-021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics