Individual
JOHN E DEFINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 W 9TH ST, BERWICK, PA 18603-3024
(570) 752-4542
(570) 752-6806
Mailing address
1207 FOWLER AVE, BERWICK, PA 18603-2307
(570) 759-0122
(570) 752-6806
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS016665L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005214650001
—
PA
01
—
099097
UNITED CONCORDIA
PA
Enumeration date
10/17/2006
Last updated
07/08/2007
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