Provider Demographics
NPI:1689733677
Name:COATS, JOHN MITCHELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MITCHELL
Last Name:COATS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7138 S HIGHLAND DR
Mailing Address - Street 2:#109
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121
Mailing Address - Country:US
Mailing Address - Phone:801-942-8686
Mailing Address - Fax:801-942-7652
Practice Address - Street 1:7138 S HIGHLAND DR
Practice Address - Street 2:#109
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121
Practice Address - Country:US
Practice Address - Phone:801-942-8686
Practice Address - Fax:801-942-7652
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14308599221223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics