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226 Chalan San Antonio Ste C Amparo's Business Center Tamuning GU 96913-3525 | |
| (671) 646-2010 | |
| (671) 646-2070 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 226 Chalan San Antonio Ste C, Tamuning, Guam |
| Authorized Official Name and Position | Kenny Wayne Bourgeois (PRESIDENT/PRIMARY DENTAL PROVIDER) |
| Authorized Official Contact | 6716462010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
226 Chalan San Antonio Ste C Amparo's Business Center Tamuning GU 96913-3525 Ph: (671) 646-2010 | 226 Chalan San Antonio Ste C Amparo's Business Center Tamuning GU 96913-3525 Ph: (671) 646-2010 |
| NPI Number | 1972733053 |
|---|---|
| Provider Enumeration Date | 07/22/2009 |
| Last Update Date | 07/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972733053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D927 (Guam) | Primary |
| 261QD0000X | Clinic/center - Dental | 14605 (Texas) | Secondary |
Hafa Adai Family Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 590 S Marine Corps Dr, Suite 104 Itc Bldg, Tamuning, GU 96913 Phone: 671-649-7851 Fax: 671-649-7853 | |
Gentle Care Dental Associates Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 278 South Marine Corp Drive, Hengi Plaza Suite 102, Tamuning, GU 96931 Phone: 671-646-8858 Fax: 671-646-3578 | |