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NPI Code Detail

MEDICARE: DR. JOHN LOIUS GUERIN D.M.D.

MEDICARE: DR. JOHN LOIUS GUERIN D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry18597MA

General Provider Information

NPI Number : 1619152345
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN LOIUS GUERIN D.M.D.
Provider Business Mailing Address
First Line : 124 COLLEGE AVE
Second Line :
City : SOMERVILLE
State : MA
Zip : 02144-1919
Country : US
Telephone Number : 617-625-0543
Fax Number :
Provider Business Practice Location Address
First Line : 124 COLLEGE AVE
Second Line :
City : SOMERVILLE
State : MA
Zip : 02144-1919
Country : US
Telephone Number : 617-625-0543
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2007
Last Update Date : 12/31/2007

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