Provider Demographics
NPI:1215127816
Name:ANTHONY J. GUGINO DDS PC
Entity type:Organization
Organization Name:ANTHONY J. GUGINO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUGINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:585-768-8010
Mailing Address - Street 1:21 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482
Mailing Address - Country:US
Mailing Address - Phone:585-768-8010
Mailing Address - Fax:
Practice Address - Street 1:21 MAIN ST.
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:NY
Practice Address - Zip Code:14482
Practice Address - Country:US
Practice Address - Phone:585-768-8010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty