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NPI Code Detail

MEDICARE: WILLIAM LEE GUTH DDS

MEDICARE: WILLIAM LEE GUTH DDS
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
1122300000XDentistD5892OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720088040
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM LEE GUTH DDS
Provider Business Mailing Address
First Line : 501 E 7TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058
Country : US
Telephone Number : 541-298-4411
Fax Number : 541-298-7798
Provider Business Practice Location Address
First Line : 501 E 7TH ST
Second Line :
City : THE DALLES
State : OR
Zip : 97058-2677
Country : US
Telephone Number : 541-298-4411
Fax Number : 541-298-7798
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 01/18/2011

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