MEDICARE: JOHN P FILUTZE D.D.S.

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	30-0-20379	OH

General Provider Information

NPI Number	:	1356365415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN P FILUTZE D.D.S.

Provider Business Mailing Address
First Line	:	3933 LANE RD
Second Line	:
City	:	PAINESVILLE
State	:	OH
Zip	:	44077-4902
Country	:	US
Telephone Number	:	440-639-2273
Fax Number	:	440-357-1646

Provider Business Practice Location Address
First Line	:	3933 LANE ROAD
Second Line	:
City	:	PERRY
State	:	OH
Zip	:	44081
Country	:	US
Telephone Number	:	440-639-2273
Fax Number	:	440-357-1646

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	03/06/2021

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