Provider Demographics
NPI:1508880782
Name:DWYER, JEFFREY F (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:F
Last Name:DWYER
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 1:1645 FALMOUTH RD
Mailing Address - Street 2:UNIT 4B
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-2932
Mailing Address - Country:US
Mailing Address - Phone:508-771-0605
Mailing Address - Fax:508-771-8480
Practice Address - Street 1:1645 FALMOUTH RD
Practice Address - Street 2:UNIT 4B
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-2932
Practice Address - Country:US
Practice Address - Phone:508-771-0605
Practice Address - Fax:508-771-8480
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice