Individual
DAISY MARIE GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DA
Contact information
Practice address
71 INNER LOOP RD, FORT IRWIN, CA 92310
(719) 526-5537
Mailing address
1631 WETZEL AVE BLDG 815, FORT CARSON, CO 80913-4095
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
08/19/2019
Last updated
08/16/2022
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