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Individual
MR. RICARDO GUILLEN
Active
Individual
MR. RICARDO GUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16837
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090501002
—
TX
01
—
82D008
BLUE CROSS BLUE SHIELD
TX
01
—
840034
UNITED CONCORDIA
TX
Enumeration date
12/21/2006
Last updated
04/19/2011
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