Provider Demographics
NPI:1528036514
Name:JANVIER, SHAUN A (DMD, PA)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:A
Last Name:JANVIER
Suffix:
Gender:M
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-3571
Mailing Address - Country:US
Mailing Address - Phone:207-324-0703
Mailing Address - Fax:207-324-2774
Practice Address - Street 1:856 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3571
Practice Address - Country:US
Practice Address - Phone:207-324-0703
Practice Address - Fax:207-324-2774
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME37481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice