MEDICARE: GERMAIN JEAN-CHARLES DDS,MS

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
1	122300000X	Dentist	056404	NY

General Provider Information

NPI Number	:	1912216789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERMAIN JEAN-CHARLES DDS,MS

Provider Business Mailing Address
First Line	:	344 N MAIN ST
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-1030
Country	:	US
Telephone Number	:	585-394-5910
Fax Number	:

Provider Business Practice Location Address
First Line	:	344 N MAIN ST
Second Line	:
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-1030
Country	:	US
Telephone Number	:	585-394-5910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2010
Last Update Date	:	03/16/2020

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