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General NPI Number Information
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NPI Number | 1831824630
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Entity Type | Individual
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Provider Name | JOSEPHINE ELLA GUAGLIARDO DDS
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Gender | Female
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 4407 MENCHACA RD
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City | AUSTIN
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State | TX
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Zip | 78745-1603
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Country | US
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Telephone | 512-892-8822
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 S LAMAR BLVD APT 372
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City | AUSTIN
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State | TX
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Zip | 78704-2580
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Country | US
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Telephone | 847-848-8895
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 38754
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License Number State | TX
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