Provider Demographics
NPI:1952889842
Name:VERAS-GIL, JENNETTE MADELINE (RDH)
Entity Type:Individual
Prefix:
First Name:JENNETTE
Middle Name:MADELINE
Last Name:VERAS-GIL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 281
Mailing Address - Street 2:
Mailing Address - City:FORESTDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02644-0281
Mailing Address - Country:US
Mailing Address - Phone:646-240-7326
Mailing Address - Fax:
Practice Address - Street 1:10 CORDAGE PARK CIR
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7318
Practice Address - Country:US
Practice Address - Phone:508-778-0300
Practice Address - Fax:508-778-5437
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH89623124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist