Provider Demographics
NPI:1760686455
Name:VANCAMP, JOHN PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:VANCAMP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:490 POST ST
Mailing Address - Street 2:SUITE 807
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1401
Mailing Address - Country:US
Mailing Address - Phone:415-397-4233
Mailing Address - Fax:415-397-7445
Practice Address - Street 1:490 POST ST
Practice Address - Street 2:SUITE 807
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1401
Practice Address - Country:US
Practice Address - Phone:415-397-4233
Practice Address - Fax:415-397-7445
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA42246OtherDENTIST LICENSE