Provider Demographics
NPI:1285312645
Name:GARCETTI RIBEIRO, GUILHERME (DDS)
Entity type:Individual
Prefix:DR
First Name:GUILHERME
Middle Name:
Last Name:GARCETTI RIBEIRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16415 SW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1019
Mailing Address - Country:US
Mailing Address - Phone:786-792-7192
Mailing Address - Fax:
Practice Address - Street 1:2900 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6365
Practice Address - Country:US
Practice Address - Phone:561-922-0052
Practice Address - Fax:561-300-7134
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL283461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice