Provider Demographics
NPI:1336962703
Name:GUY, JANA (RDH)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:GUY
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 1:1676 TED DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38572-3152
Mailing Address - Country:US
Mailing Address - Phone:423-718-1720
Mailing Address - Fax:
Practice Address - Street 1:1357 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-6184
Practice Address - Country:US
Practice Address - Phone:931-787-1277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004983124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist