Provider Demographics
NPI:1881821858
Name:PELLAND, JOHN FRANCIS (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:PELLAND
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 1:2002 DEL PRADO BLVD.
Mailing Address - Street 2:STE 202
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-4557
Mailing Address - Country:US
Mailing Address - Phone:239-574-2710
Mailing Address - Fax:
Practice Address - Street 1:2002 DEL PRADO BLVD.
Practice Address - Street 2:STE 202
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-4557
Practice Address - Country:US
Practice Address - Phone:239-574-2710
Practice Address - Fax:239-574-7839
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN79421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice