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General NPI Number Information
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NPI Number | 1760899553
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Entity Type | Organization
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Legal Business Name | JOHN L. POTTER, DMD PC
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 3131 COLLEGE HEIGHTS BLVD STE 2800
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City | ALLENTOWN
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State | PA
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Zip | 18104-4812
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Country | US
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Telephone | 610-433-2300
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Fax | 610-433-4592
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Provider Business Mailing Address
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Address Line | 3131 COLLEGE HEIGHTS BLVD STE 2800
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City | ALLENTOWN
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State | PA
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Zip | 18104-4812
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Country | US
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Telephone | 610-433-2300
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Fax | 610-433-4592
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Authorized Official
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Title or Position | PERIODONTIST
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Name | DR. JOHN L POTTER JR.
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Credential | DMD PC
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Telephone | 610-433-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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License Number | DSL028897L
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License Number State | PA
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