MEDICARE: PATRICIA A. GUERRERO, DDS, A PROFESSIONAL CORP

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	50060	CA

General Provider Information

NPI Number	:	1710255914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA A. GUERRERO, DDS, A PROFESSIONAL CORP

Provider Business Mailing Address
First Line	:	27943 SECO CANYON RD # 103
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91350-3872
Country	:	US
Telephone Number	:	661-513-1435
Fax Number	:

Provider Business Practice Location Address
First Line	:	27730 MCBEAN PKWY
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-1430
Country	:	US
Telephone Number	:	661-513-1435
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. PATRICIA A GUERRERO
Credential	:	DDS
Telephone Number	:	661-513-1435

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	12/02/2011

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