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General NPI Number Information
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NPI Number | 1508965997
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Entity Type | Individual
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Provider Name | JESSICA ANNE GUY D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 175 E BROWN ST CACH/VALERIE M.HODGE MEMORIAL DENTAL CENTER, SUITE 114
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3098
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Country | US
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Telephone | 570-476-3506
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Fax | 570-421-9014
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Provider Business Mailing Address
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Address Line | HC 1 BOX C9
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City | SWIFTWATER
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State | PA
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Zip | 18370-9732
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Country | US
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Telephone | 570-839-3972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS036240
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License Number State | PA
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