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General NPI Number Information
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NPI Number | 1457735342
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Entity Type | Individual
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Provider Name | JASMIN GUZMAN DMD
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Gender | Female
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Dates
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Enumeration Date | 07/10/2015
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3860 W OGDEN AVE
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City | CHICAGO
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State | IL
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Zip | 60623-2460
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Country | US
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Telephone | 872-588-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 3212 S LEAVITT ST
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City | CHICAGO
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State | IL
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Zip | 60608-6017
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Country | US
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Telephone | 773-936-2227
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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 | 019030256
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License Number State | IL
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