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General NPI Number Information
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NPI Number | 1013213131
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Entity Type | Organization
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Legal Business Name | JEROME A GUTTMAN DENTAL PRACTICE, INC
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 211 CULVER BLVD SUITE T
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-7788
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Country | US
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Telephone | 310-827-5094
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Fax | 310-821-3417
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Provider Business Mailing Address
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Address Line | 211 CULVER BLVD SUITE T
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City | PLAYA DEL REY
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State | CA
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Zip | 90293-7788
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Country | US
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Telephone | 310-827-5094
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Fax | 310-821-3417
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEROME ALAN GUTTMAN
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Credential | D.D.S.
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Telephone | 310-827-5094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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