Provider Demographics
NPI:1235279613
Name:BECHERER, JOHN C (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:BECHERER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5800 BAYSHORE DR N
Mailing Address - Street 2:#B252
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4516
Mailing Address - Country:US
Mailing Address - Phone:414-332-4123
Mailing Address - Fax:414-332-4264
Practice Address - Street 1:5800 N. BAYSHORE DR.
Practice Address - Street 2:#B252
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-4516
Practice Address - Country:US
Practice Address - Phone:414-332-4123
Practice Address - Fax:414-332-4264
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4390-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist