Provider Demographics
NPI:1982114989
Name:WEEKS, GILLIAN MAGGIORE (DMD)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:MAGGIORE
Last Name:WEEKS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FLINTLOCK DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-2004
Mailing Address - Country:US
Mailing Address - Phone:617-962-1414
Mailing Address - Fax:
Practice Address - Street 1:861 HANOVER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5419
Practice Address - Country:US
Practice Address - Phone:603-232-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18577461223G0001X
NH043561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice