Provider Demographics
NPI:1336428275
Name:GUTENBERG, LAUREN LOUISE (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:LOUISE
Last Name:GUTENBERG
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 STERLING RD
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6675
Mailing Address - Country:US
Mailing Address - Phone:909-499-7318
Mailing Address - Fax:
Practice Address - Street 1:490 S FARRELL DR
Practice Address - Street 2:STE. C-101
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7992
Practice Address - Country:US
Practice Address - Phone:760-320-7621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA594151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry