Provider Demographics
NPI:1982257796
Name:NORTHROP, JOHN PARKER
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PARKER
Last Name:NORTHROP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 836 BOX 2670
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09636-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:S. S. 192, KM. 76
Practice Address - Street 2:
Practice Address - City:CATANIA
Practice Address - State:CATANIA
Practice Address - Zip Code:95100
Practice Address - Country:IT
Practice Address - Phone:314-624-4877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-21
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist