Healthcare Provider Details

I. General information

NPI: 1952583411
Provider Name (Legal Business Name): JOHN J DANN III MD DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 MORAGA RD STE 7
LAFAYETTE CA
94549-5039
US

IV. Provider business mailing address

895 MORAGA RD STE 7
LAFAYETTE CA
94549-5039
US

V. Phone/Fax

Practice location:
  • Phone: 925-283-1212
  • Fax: 925-283-1217
Mailing address:
  • Phone: 925-283-1212
  • Fax: 925-283-1217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG41331
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN J DANN III
Title or Position: OWNER
Credential: D.M.D, M.D.
Phone: 925-283-1212