Provider Demographics
NPI:1316132707
Name:GUZMAN, KEVIN ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ANTHONY
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4057
Mailing Address - Country:US
Mailing Address - Phone:480-922-0600
Mailing Address - Fax:
Practice Address - Street 1:13430 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4057
Practice Address - Country:US
Practice Address - Phone:480-922-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ69961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice