# DR. JOHN R GARRARD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124056544
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D-3400 | ID | Yes |

## Other

- **Enumeration date:** 06/28/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010135366 | REGENCE BLUE SHIELD | — |
| 01 | — | 1444442 | UNITED CONCORDIA | — |
| 01 | — | 3400 | DELTA DENTAL | ID |
| 01 | — | 6F688 | BLUE CROSS | ID |