Provider Demographics
NPI:1104913953
Name:TRAPP, JOHN
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:TRAPP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15705 CANTERBURY CHASE
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-8029
Mailing Address - Country:US
Mailing Address - Phone:404-275-5557
Mailing Address - Fax:770-441-0299
Practice Address - Street 1:13 CORPORATE SQUARE
Practice Address - Street 2:SUITE 120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329
Practice Address - Country:US
Practice Address - Phone:678-836-2120
Practice Address - Fax:770-441-0299
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0098561223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics