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NPI Code Detail

MEDICARE: DR. RICHARD GUTIERREZ DDS,MS, INC.

MEDICARE: DR. RICHARD GUTIERREZ DDS,MS, INC.
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number : 1962558981
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. RICHARD GUTIERREZ DDS,MS, INC.
Provider Business Mailing Address
First Line : 2011 ROSS AVE
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-3686
Country : US
Telephone Number : 760-370-0770
Fax Number : 760-370-0774
Provider Business Practice Location Address
First Line : 2011 ROSS AVE
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-3686
Country : US
Telephone Number : 760-370-0770
Fax Number : 760-370-0774
Authorized Official
Title or Position : ORTHODONTIST
Name : DR. RICHARD GUTIERREZ
Credential : D.D.S. M.S.
Telephone Number : 760-370-0770
Provider Enumeration Date : 01/25/2007
Last Update Date : 06/25/2008

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