Provider Demographics
NPI:1629237425
Name:GUARENTE, JOHN FREDERIC (DMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FREDERIC
Last Name:GUARENTE
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 1:2 NIRVANA DR
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-1286
Mailing Address - Country:US
Mailing Address - Phone:781-231-3157
Mailing Address - Fax:
Practice Address - Street 1:2 NIRVANA DR
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-1286
Practice Address - Country:US
Practice Address - Phone:781-231-3157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17540122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist