Provider Demographics
NPI:1770647208
Name:OSHETSKI, JOHN ANTHONY (DDS-MSD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:OSHETSKI
Suffix:
Gender:M
Credentials:DDS-MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 WINCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-8849
Mailing Address - Country:US
Mailing Address - Phone:530-878-1926
Mailing Address - Fax:
Practice Address - Street 1:9340 W STOCKTON BLVD
Practice Address - Street 2:110
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8014
Practice Address - Country:US
Practice Address - Phone:916-684-0520
Practice Address - Fax:916-684-0521
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics