Individual
PATRICK GUEVARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1732 S BROAD ST, PHILADELPHIA, PA 19145-2330
(215) 336-8391
Mailing address
1509 W MASTER ST, PHILADELPHIA, PA 19121-4890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS044028
PA
Other
Enumeration date
05/04/2023
Last updated
05/05/2023
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