Provider Demographics
NPI:1336927219
Name:GUIDO, ANDREA (DDS)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:GUIDO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:633 MORNINGHOME RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4152
Mailing Address - Country:US
Mailing Address - Phone:707-293-8487
Mailing Address - Fax:
Practice Address - Street 1:6660 LONE TREE WAY STE 7
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5310
Practice Address - Country:US
Practice Address - Phone:925-513-8363
Practice Address - Fax:925-513-7508
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1094871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice