Provider Demographics
NPI:1689722233
Name:BACHMANN, JOHN T (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:BACHMANN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1047 JEFF RD NW
Mailing Address - Street 2:MONROVIA PLAZA SUITE 3
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-4232
Mailing Address - Country:US
Mailing Address - Phone:256-489-3065
Mailing Address - Fax:256-489-3638
Practice Address - Street 1:1047 JEFF RD NW
Practice Address - Street 2:MONROVIA PLAZA SUITE 3
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4232
Practice Address - Country:US
Practice Address - Phone:256-489-3065
Practice Address - Fax:256-489-3638
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics