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General NPI Number Information
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NPI Number | 1477738912
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Entity Type | Organization
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Legal Business Name | JOHN L GUERIN D.M.D PC
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 2171 MAIN ST
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City | TEWKSBURY
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State | MA
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Zip | 01876-3028
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Country | US
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Telephone | 978-988-1298
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Fax |
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Provider Business Mailing Address
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Address Line | 2171 MAIN ST
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City | TEWKSBURY
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State | MA
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Zip | 01876-3028
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Country | US
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Telephone | 978-988-1298
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Fax |
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Authorized Official
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Title or Position | DENTIST / OWNER
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Name | DR. JOHN LOIUS GUERIN
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Credential | D.M.D.
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Telephone | 978-988-1298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18597
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License Number State | MA
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