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General NPI Number Information
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NPI Number | 1790344406
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Entity Type | Individual
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Provider Name | LUIS GERARDO GUZMAN SUAREZ DDS, MS, DMD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 670 N COLLEGE ST STE D
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City | AUBURN
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State | AL
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Zip | 36830-3030
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Country | US
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Telephone | 334-209-1352
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Fax | 334-460-9728
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Provider Business Mailing Address
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Address Line | 670 N COLLEGE ST STE D
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City | AUBURN
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State | AL
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Zip | 36830-3030
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Country | US
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Telephone | 334-209-1352
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Fax | 334-460-9728
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 0006625
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 0006625
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License Number State | AL
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