Individual
DR. JOHN WILLIAM KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6401
(505) 368-6431
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6401
(505) 368-6431
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1653
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432443
—
AZ
05
—
75005743
—
CO
05
—
S3075
—
NM
Enumeration date
10/06/2005
Last updated
09/20/2007
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