Provider Demographics
NPI:1902298037
Name:GUEVARRA YOU, JEAN LAURICE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEAN LAURICE
Middle Name:
Last Name:GUEVARRA YOU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JEAN LAURICE
Other - Middle Name:
Other - Last Name:GUEVARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:504 W WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1846
Mailing Address - Country:US
Mailing Address - Phone:919-303-2873
Mailing Address - Fax:
Practice Address - Street 1:504 W WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502
Practice Address - Country:US
Practice Address - Phone:191-303-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113041223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program