Individual
DR. JASMIN GUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(872) 588-3000
Mailing address
3212 S LEAVITT ST, CHICAGO, IL 60608-6017
(773) 936-2227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030256
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019030256
STATE LICENSE
IL
01
—
319019530
CDS
IL
05
—
728780
—
IL
Enumeration date
07/10/2015
Last updated
03/07/2023
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