Provider Demographics
NPI:1891832796
Name:MCLAUGHLIN, JOHN MERLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MERLE
Last Name:MCLAUGHLIN
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 1:1515 E CEDAR AVE
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-1600
Mailing Address - Country:US
Mailing Address - Phone:928-774-4831
Mailing Address - Fax:928-214-6073
Practice Address - Street 1:1515 E CEDAR AVE
Practice Address - Street 2:SUITE C-1
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1600
Practice Address - Country:US
Practice Address - Phone:928-774-4831
Practice Address - Fax:928-214-6073
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD17991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice