MEDICARE: DR. JOHNATHAN P EARP 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
1	1223G0001X	General Practice Dentistry	7513	NC

General Provider Information

NPI Number	:	1982769378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHNATHAN P EARP DDS

Provider Business Mailing Address
First Line	:	2401 CHARLES BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5925
Country	:	US
Telephone Number	:	252-756-3313
Fax Number	:	252-756-0146

Provider Business Practice Location Address
First Line	:	2401 CHARLES BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5925
Country	:	US
Telephone Number	:	252-756-3313
Fax Number	:	252-756-0146

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. JOHNATHAN P EARP DDS” Practice Location

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