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General NPI Number Information
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NPI Number | 1134250848
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Entity Type | Organization
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Legal Business Name | MARIA GUADALUPE ESTRADA-GUEVARA DDS,INC.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 1072A 3RD AVE
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City | CHULA VISTA
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State | CA
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Zip | 91911-2009
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Country | US
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Telephone | 619-425-5323
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Fax |
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Provider Business Mailing Address
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Address Line | 1072A 3RD AVE
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City | CHULA VISTA
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State | CA
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Zip | 91911-2009
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Country | US
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Telephone | 619-425-5323
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | MARIA GUADALUPE ESTRADA-GUEVARA
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Credential | D.D.S.
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Telephone | 619-425-5323
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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 | 36361
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License Number State | CA
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