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Organization
MARIA TERESA R DE GUZMAN DDS CORP
Active
Organization
MARIA TERESA R DE GUZMAN DDS CORP
Active
Other names
MyToothSpa Dentistry and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY ESCANO DEGUZMAN SR. (ADMINISTARTOR)
(916) 919-5721
Entity
Organization
Contact information
Practice address
2436 PROFESSIONAL DR, SUITE 200, ROSEVILLE, CA 95661-7779
(916) 774-9920
(916) 910-0752
Mailing address
5060 SUNRISE BLVD, SUITE A3, FAIR OAKS, CA 95628-4944
(916) 919-5721
(916) 910-0751
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
41390
CA
305R00000X
Preferred Provider Organization
41390
CA
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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