Provider Demographics
NPI:1104060698
Name:PEERY, JAMES MCGUIRE III (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MCGUIRE
Last Name:PEERY
Suffix:III
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 1:2229 MURRELL RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501
Mailing Address - Country:US
Mailing Address - Phone:434-847-5331
Mailing Address - Fax:434-847-6665
Practice Address - Street 1:2229 MURRELL RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501
Practice Address - Country:US
Practice Address - Phone:434-847-5331
Practice Address - Fax:434-847-6665
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0401412504122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program