Provider Demographics
NPI:1912190059
Name:PAPPAS, JOHN P (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 STUART ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5019
Mailing Address - Country:US
Mailing Address - Phone:617-266-6020
Mailing Address - Fax:617-266-0203
Practice Address - Street 1:441 STUART ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5019
Practice Address - Country:US
Practice Address - Phone:617-266-6020
Practice Address - Fax:617-266-0203
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice