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General NPI Number Information
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NPI Number | 1386220556
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Entity Type | Organization
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Legal Business Name | DANIEL F. GUERRA DMD, LLC
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 517 MAIN ST
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City | FENTON
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State | MO
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Zip | 63026-4103
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Country | US
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Telephone | 636-343-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 6955 MAGONA CT
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City | MARYVILLE
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State | IL
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Zip | 62062-8554
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Country | US
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Telephone | 618-550-2485
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. DANIEL F GUERRA
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Credential | DMD
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Telephone | 618-550-2485
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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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