Provider Demographics
NPI:1104261023
Name:MIZUKAWA, JOHN HIDEO II (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HIDEO
Last Name:MIZUKAWA
Suffix:II
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1308 E 900 S STE A
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8730
Mailing Address - Country:US
Mailing Address - Phone:435-673-1554
Mailing Address - Fax:865-482-8686
Practice Address - Street 1:1308 E 900 S STE A
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8730
Practice Address - Country:US
Practice Address - Phone:435-673-1554
Practice Address - Fax:435-674-9967
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2023-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT129189321223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery