MEDICARE: DR. JORGE A GUEL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	15323	TX

General Provider Information

NPI Number	:	1023133196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE A GUEL D.D.S.

Provider Business Mailing Address
First Line	:	3138 SE MILITARY DR STE 104
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-3894
Country	:	US
Telephone Number	:	210-533-1100
Fax Number	:	210-333-3363

Provider Business Practice Location Address
First Line	:	3138 SE MILITARY DR STE 104
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-3894
Country	:	US
Telephone Number	:	210-533-1100
Fax Number	:	210-333-3363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/09/2007

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