Provider Demographics
NPI:1699714105
Name:PICK, JOHN BARTHOLOMEW (DMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:BARTHOLOMEW
Last Name:PICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25880 TOURNAMENT RD
Mailing Address - Street 2:STE 218
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2845
Mailing Address - Country:US
Mailing Address - Phone:661-259-1133
Mailing Address - Fax:661-259-1163
Practice Address - Street 1:25880 TOURNAMENT RD
Practice Address - Street 2:STE 218
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2845
Practice Address - Country:US
Practice Address - Phone:661-259-1133
Practice Address - Fax:661-259-1163
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery