MEDICARE: DR. JOHN J. HIGGINS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5607	MD

General Provider Information

NPI Number	:	1184702201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN J. HIGGINS D.D.S.

Provider Business Mailing Address
First Line	:	108 ESWORTHY PL
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-8723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5648 SHIELDS DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-3574
Country	:	US
Telephone Number	:	301-530-8008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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