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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JOHN W ETZENBACH, DDS

Active

DR. JOHN W ETZENBACH, DDS is a Periodontology healthcare provider located in TRIPLER AMC, Hawaii. NPI 1790740322 is currently active in the NPPES registry. Verify at CMS.

Periodontology · TRIPLER AMC, HI

Registration Details

NPI Number
1790740322
Provider Type
Individual
Gender
Male
NPI Issued
Apr 18, 2006 (20.29089784533 yrs)
Last Updated
Feb 5, 2015
Licenses
019018177 (IL)
2192 (HI)
52815 (CA)

Practice Information

Address
1 JARRETT WHITE RD BLDG 320
US ARMY DENTAL ACTIVITY
TRIPLER AMC, HI, 968595001
Browse HI providers · Browse ZIP 96859
Phone
8084339200
Fax
8084339194
Primary Specialty
Periodontology
1223P0300X
Additional Specialty
Periodontology
Additional Specialty
Periodontology

Other Periodontology Providers in TRIPLER AMC, HI

Name Credential NPI
GREGORY ALAN BLYTHE DDS 1982685749
DR. DONALD KARL SCALES DDS 1265419493
DR. BRIAN WILLIAM STANCOVEN DDS 1508823840
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.