MEDICARE: DR. CHRISTINE GUARDINO DMD

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	040025-1	NY

General Provider Information

NPI Number	:	1598828402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE GUARDINO DMD

Provider Business Mailing Address
First Line	:	9736 TRANSIT RD
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-1311
Country	:	US
Telephone Number	:	716-688-5717
Fax Number	:	716-204-9028

Provider Business Practice Location Address
First Line	:	9736 TRANSIT RD
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-1311
Country	:	US
Telephone Number	:	716-688-5717
Fax Number	:	716-204-9028

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	01/28/2014

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