Provider Demographics
NPI:1932112497
Name:GUEST, JEFFERY PAUL II (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:PAUL
Last Name:GUEST
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 HOWELL DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1530
Mailing Address - Country:US
Mailing Address - Phone:740-344-7770
Mailing Address - Fax:
Practice Address - Street 1:1534 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1532
Practice Address - Country:US
Practice Address - Phone:740-344-4549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-40871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice