Provider Demographics
NPI:1720083397
Name:DUCAR, JOHN PHILLIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PHILLIP
Last Name:DUCAR
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 1:4201 TORRANCE BLVD
Mailing Address - Street 2:STE 450
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4592
Mailing Address - Country:US
Mailing Address - Phone:310-540-1415
Mailing Address - Fax:310-540-1423
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:STE 450
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4592
Practice Address - Country:US
Practice Address - Phone:310-540-1415
Practice Address - Fax:310-540-1423
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA354881223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics