Provider Demographics
NPI:1578574794
Name:CALHOUN, JOHN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:CALHOUN
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 1:195 MONTOWESE ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405
Mailing Address - Country:US
Mailing Address - Phone:203-483-7862
Mailing Address - Fax:203-483-5388
Practice Address - Street 1:195 MONTOWESE ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405
Practice Address - Country:US
Practice Address - Phone:203-483-7862
Practice Address - Fax:203-483-5388
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT90831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics