MEDICARE: DR. JOHN S PAFFRATH 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	DS4216	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114980349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN S PAFFRATH DDS

Provider Business Mailing Address
First Line	:	4889 EAST MAIN STREET
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061-4115
Country	:	US
Telephone Number	:	931-289-4228
Fax Number	:	931-289-5832

Provider Business Practice Location Address
First Line	:	4889 EAST MAIN STREET
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061-4115
Country	:	US
Telephone Number	:	931-289-4228
Fax Number	:	931-289-5832

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	07/15/2014

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