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General NPI Number Information
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NPI Number | 1225265127
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Entity Type | Individual
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Provider Name | SANDRA GUERECA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 11/16/2009
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Provider Practice Location Address
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Address Line | 24901 SANTA CLARA ST STE B2
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City | HAYWARD
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State | CA
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Zip | 94544-2147
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Country | US
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Telephone | 510-887-6835
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Fax | 510-887-2872
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Provider Business Mailing Address
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Address Line | 23630 CARLSON CT
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City | HAYWARD
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State | CA
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Zip | 94541-4583
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Country | US
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Telephone | 510-728-9842
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Fax | 510-887-2872
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 53794
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License Number State | CA
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