Provider Demographics
NPI:1063743300
Name:FIRTH, JOHN RALPH (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RALPH
Last Name:FIRTH
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:3890 SO. LINDBERGH BLVD.
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SUNSET HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-843-5553
Mailing Address - Fax:314-849-6764
Practice Address - Street 1:3890 SO. LINDBERGH BLVD.
Practice Address - Street 2:SUITE 115
Practice Address - City:SUNSET HILLS
Practice Address - State:MO
Practice Address - Zip Code:63127
Practice Address - Country:US
Practice Address - Phone:314-843-5553
Practice Address - Fax:314-849-6764
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO0155761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics