Provider Demographics
NPI:1861678906
Name:SINCLAIR, JOHN LEWIS JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEWIS
Last Name:SINCLAIR
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:LEWIS
Other - Last Name:SINCLAIR
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1900 WHITES RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2872
Mailing Address - Country:US
Mailing Address - Phone:269-344-2652
Mailing Address - Fax:269-344-8002
Practice Address - Street 1:1900 WHITES RD
Practice Address - Street 2:SUITE 4
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2872
Practice Address - Country:US
Practice Address - Phone:269-344-2652
Practice Address - Fax:269-344-8002
Is Sole Proprietor?:No
Enumeration Date:2008-01-19
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI012589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist