Provider Demographics
NPI:1518939248
Name:ETRE, GEORGE W (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:W
Last Name:ETRE
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 1:700 ATTUCKS LN
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1811
Mailing Address - Country:US
Mailing Address - Phone:508-771-4320
Mailing Address - Fax:508-775-4384
Practice Address - Street 1:700 ATTUCKS LN
Practice Address - Street 2:SUITE 2C
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1811
Practice Address - Country:US
Practice Address - Phone:508-771-4320
Practice Address - Fax:508-775-4384
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA027651223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics