Individual
DR. JOHN W ETZENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 JARRETT WHITE RD BLDG 320, US ARMY DENTAL ACTIVITY, TRIPLER AMC, HI 96859-5001
(808) 433-9200
(808) 433-9194
Mailing address
1 JARRETT WHITE RD BLDG 320, US ARMY DENTAL ACTIVITY, TRIPLER AMC, HI 96859-5001
(808) 433-9200
(808) 433-9194
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
019018177
IL
1223P0300X
Periodontics
Primary
2192
HI
1223P0300X
Periodontics
52815
CA
Other
Enumeration date
04/18/2006
Last updated
02/05/2015
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