Provider Demographics
NPI:1629290044
Name:SHAUN JANVIER, DMD, PA
Entity Type:Organization
Organization Name:SHAUN JANVIER, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:JANVIER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-324-0703
Mailing Address - Street 1:856 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073
Mailing Address - Country:US
Mailing Address - Phone:207-324-0703
Mailing Address - Fax:207-324-2774
Practice Address - Street 1:856 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073
Practice Address - Country:US
Practice Address - Phone:207-324-0703
Practice Address - Fax:207-324-2774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3748122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty