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NPI Code Detail

MEDICARE: JOHN JOW DDS

MEDICARE: JOHN JOW DDS
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
11223P0700XProsthodontics25553CA

General Provider Information

NPI Number : 1750364287
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN JOW DDS
Provider Business Mailing Address
First Line : 1023 WIGET LANE
Second Line :
City : WALNUT CREEK
State : CA
Zip : 94598
Country : US
Telephone Number : 707-562-8225
Fax Number : 707-562-8247
Provider Business Practice Location Address
First Line : 2101 COURAGE DR
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number : 707-784-2120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 02/20/2013

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