Individual
DR. JOHN PHILLIP WASCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
560 NE E ST, GRANTS PASS, OR 97526-2326
(541) 476-8383
(541) 470-0751
Mailing address
560 NE E ST, GRANTS PASS, OR 97526-2326
(541) 476-8383
(541) 470-0751
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
55033
CA
1223P0221X
Pediatric Dentistry
Primary
D9097
OR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
55033
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D9097
OR
Other
Enumeration date
07/23/2007
Last updated
12/15/2009
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