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NPI Code Detail

MEDICARE: DR. ADRIANA GUEVARA D.D.S.

MEDICARE: DR. ADRIANA GUEVARA 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
1122300000XDentist4746-015WI

General Provider Information

NPI Number : 1053598268
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADRIANA GUEVARA D.D.S.
Provider Business Mailing Address
First Line : 2816 E HARTFORD AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53211-3147
Country : US
Telephone Number : 414-645-0365
Fax Number : 414-645-1052
Provider Business Practice Location Address
First Line : 3520 W OKLAHOMA AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4175
Country : US
Telephone Number : 414-645-0365
Fax Number : 414-645-1052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2008
Last Update Date : 01/30/2008

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