Provider Demographics
NPI:1033117965
Name:PEARSON, JOHN K (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:K
Last Name:PEARSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:910 WASHBURN AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-4348
Mailing Address - Country:US
Mailing Address - Phone:951-737-5861
Mailing Address - Fax:951-737-5864
Practice Address - Street 1:910 WASHBURN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-4348
Practice Address - Country:US
Practice Address - Phone:951-737-5861
Practice Address - Fax:951-737-5864
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD206561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics