Healthcare Provider Details

I. General information

NPI: 1639347917
Provider Name (Legal Business Name): JOHN PATRICK FINUCANE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 2ND AVE
WORTHINGTON MN
56187-2380
US

IV. Provider business mailing address

1027 2ND AVE
WORTHINGTON MN
56187-2380
US

V. Phone/Fax

Practice location:
  • Phone: 507-372-7339
  • Fax:
Mailing address:
  • Phone: 507-372-7339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD13709
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD13709
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: