Provider Demographics
NPI:1578541538
Name:GUILLOT, JOHN LOUIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LOUIS
Last Name:GUILLOT
Suffix:
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 1:49 CROSS CREEK PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1587
Mailing Address - Country:US
Mailing Address - Phone:601-264-5800
Mailing Address - Fax:601-450-0064
Practice Address - Street 1:49 CROSS CREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1587
Practice Address - Country:US
Practice Address - Phone:601-264-5800
Practice Address - Fax:601-450-0064
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2872-95122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist