Individual
ISMAEL GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
GA
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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