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General NPI Number Information
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NPI Number | 1316476468
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Entity Type | Individual
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Provider Name | SYDNEY ELIZABETH GUIDROZ DDS
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Gender | Female
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Dates
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Enumeration Date | 06/11/2017
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 3100 S CONGRESS AVE # 1F
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City | AUSTIN
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State | TX
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Zip | 78704-6462
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Country | US
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Telephone | 512-717-3147
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Fax |
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Provider Business Mailing Address
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Address Line | 4646 MUELLER BLVD APT 4075
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City | AUSTIN
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State | TX
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Zip | 78723-3431
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Country | US
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Telephone | 601-807-3756
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 33060
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33060
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License Number State | TX
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