Provider Demographics
NPI:1033776992
Name:TSOUGRANIS, GEORGE HARRY (DMD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:HARRY
Last Name:TSOUGRANIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 E PIER DR APT 2530
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-2955
Mailing Address - Country:US
Mailing Address - Phone:603-988-9660
Mailing Address - Fax:
Practice Address - Street 1:282 ELM ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-4320
Practice Address - Country:US
Practice Address - Phone:978-388-3505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18582711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice