Provider Demographics
NPI:1437278199
Name:GEARY, JOHN WESLEY JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESLEY
Last Name:GEARY
Suffix:JR
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 1:1216 N CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-1628
Mailing Address - Country:US
Mailing Address - Phone:814-444-0378
Mailing Address - Fax:814-444-0649
Practice Address - Street 1:1216 N CENTER AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1628
Practice Address - Country:US
Practice Address - Phone:814-444-0378
Practice Address - Fax:814-444-0649
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028096L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice