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Individual

JOSE DE LA GUERRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-6000
Mailing address
104 PRIVATE PL, GREENACRES, FL 33413-2147
(561) 329-6605

Taxonomy

Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary

Other

Enumeration date
05/21/2021
Last updated
09/08/2021
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