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General NPI Number Information
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NPI Number | 1053617969
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Entity Type | Organization
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Legal Business Name | PETER M. GUTIERREZ, D.D.S. AND KATHERINE SCURES-GUTIERREZ, D.D.S., P.A
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Dates
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Enumeration Date | 02/10/2011
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Last Update Date | 02/10/2011
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Provider Practice Location Address
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Address Line | 373 SEBASTIAN BLVD
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City | SEBASTIAN
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State | FL
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Zip | 32958-4550
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Country | US
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Telephone | 772-589-7409
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Fax | 772-589-0777
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Provider Business Mailing Address
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Address Line | 373 SEBASTIAN BLVD
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City | SEBASTIAN
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State | FL
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Zip | 32958-4550
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Country | US
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Telephone | 772-589-7409
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Fax | 772-589-0777
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. KATHERINE SCURES-GUTIERREZ
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Credential | DDS
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Telephone | 772-589-7409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN10063
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License Number State | FL
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