Provider Demographics
NPI:1881210573
Name:DUERR, JOHN PATRICK (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:DUERR
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 1:3680 EATON GATE LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-3892
Mailing Address - Country:US
Mailing Address - Phone:248-895-0645
Mailing Address - Fax:
Practice Address - Street 1:18618 MIDDLEBELT RD STE 105
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3586
Practice Address - Country:US
Practice Address - Phone:248-476-1960
Practice Address - Fax:248-479-2805
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016004881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice