Individual
DR. JOHN DOUGLAS PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
204 W PAIGE STREET, TOMPKINSVILLE, KY 42167
(270) 487-5196
(270) 487-5196
Mailing address
204 W PAIGE STREET, PO BOX 249, TOMPKINSVILLE, KY 42167
(270) 487-5196
(270) 487-5196
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7984
KY
1223P0221X
Pediatric Dentistry
7984
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60002268
—
KY
Enumeration date
04/11/2007
Last updated
05/19/2011
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