Healthcare Provider Details

I. General information

NPI: 1346400702
Provider Name (Legal Business Name): CHELSEA K GUZZO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 07/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 FRANKFORT HWY
FRANKFORT MI
49635-9292
US

IV. Provider business mailing address

1036 BAYSIDE DR
TRAVERSE CITY MI
49686-9205
US

V. Phone/Fax

Practice location:
  • Phone: 231-352-9221
  • Fax:
Mailing address:
  • Phone: 309-558-7874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901021763
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6267-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: