Provider Demographics
NPI:1912216789
Name:JEAN-CHARLES, GERMAIN (DDS,MS)
Entity Type:Individual
Prefix:
First Name:GERMAIN
Middle Name:
Last Name:JEAN-CHARLES
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1030
Mailing Address - Country:US
Mailing Address - Phone:585-394-5910
Mailing Address - Fax:
Practice Address - Street 1:344 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1030
Practice Address - Country:US
Practice Address - Phone:585-394-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist