Provider Demographics
NPI:1699745091
Name:MCLAUGHLIN, JOHN P (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 BLAKESLEE BOULEVARD DR E
Mailing Address - Street 2:ROUTE 443
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-8753
Mailing Address - Country:US
Mailing Address - Phone:610-377-1942
Mailing Address - Fax:610-377-3070
Practice Address - Street 1:1080 BLAKESLEE BOULEVARD DR E
Practice Address - Street 2:ROUTE 443
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-8753
Practice Address - Country:US
Practice Address - Phone:610-377-1942
Practice Address - Fax:610-377-3070
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021514L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACA524925OtherGROUP BS/UC #
PAMC977121OtherINDIVIDUAL UC/BS#
PAU78890Medicare UPIN
PAMC977121OtherINDIVIDUAL UC/BS#