Provider Demographics
NPI:1467468504
Name:GUERIN, ELIOT DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIOT
Middle Name:DAVID
Last Name:GUERIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424A HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3128
Mailing Address - Country:US
Mailing Address - Phone:504-265-0822
Mailing Address - Fax:888-408-9405
Practice Address - Street 1:424A HARRISON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3128
Practice Address - Country:US
Practice Address - Phone:504-265-0822
Practice Address - Fax:888-408-9405
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA42811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice