Provider Demographics
NPI:1356530281
Name:PROPES, JOHN ANDREW (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANDREW
Last Name:PROPES
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 1:104 PARK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-722-6203
Mailing Address - Fax:209-722-2547
Practice Address - Street 1:104 PARK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348
Practice Address - Country:US
Practice Address - Phone:209-722-6203
Practice Address - Fax:209-722-2547
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA47780122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist