Provider Demographics
NPI:1669643037
Name:PELAYO, GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:PELAYO
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 1:481 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-3152
Mailing Address - Country:US
Mailing Address - Phone:508-697-0107
Mailing Address - Fax:
Practice Address - Street 1:481 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-3152
Practice Address - Country:US
Practice Address - Phone:508-697-0107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics