Provider Demographics
NPI:1871754325
Name:PAPADOPOULOS, JOHN D (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:PAPADOPOULOS
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 1:2765 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8565
Mailing Address - Country:US
Mailing Address - Phone:517-546-3440
Mailing Address - Fax:517-546-3233
Practice Address - Street 1:2765 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8565
Practice Address - Country:US
Practice Address - Phone:517-546-3440
Practice Address - Fax:517-546-3233
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010198411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice