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NPI Code Detail

MEDICARE: JOHN A. KOMTOPANOS JR. DDS

MEDICARE:   JOHN A. KOMTOPANOS JR. 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
11223G0001XGeneral Practice Dentistry0401002678VA

General Provider Information

NPI Number : 1770730210
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN A. KOMTOPANOS JR. DDS
Provider Business Mailing Address
First Line : 4031 FALSTONE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23234-4255
Country : US
Telephone Number : 804-275-8959
Fax Number :
Provider Business Practice Location Address
First Line : 4031 FALSTONE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23234-4255
Country : US
Telephone Number : 804-275-8959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2008
Last Update Date : 08/27/2008

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Directions to “ JOHN A. KOMTOPANOS JR. DDS” Practice Location

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