Etzenbach, John W
Etzenbach, John W is an individual health care provider with primary practice located at 1 Jarrett White Rd Bldg 320 Us Army Dental Activity, Tripler Amc HI 96859-5001. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Etzenbach, John W can be contacted via phone (808) 433-9200.Contact Information
Primary practice address
1 Jarrett White Rd Bldg 320 Us Army Dental Activity
Tripler Amc HI 96859-5001
Phone: (808) 433-9200
Fax: (808) 433-9194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 019018177 | Illinois |
| Dental Providers / Periodontics | 1223P0300X | 2192 | Hawaii |
| Dental Providers / Periodontics | 1223P0300X | 52815 | California |
Profile Details
| NPI number | 1790740322 |
|---|---|
| LBN Legal business name | Etzenbach, John W |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 18th, 2006 |
| Last updated | Feb 5th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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