Provider Demographics
NPI:1427248152
Name:GUEVARRA, PHILIP (DDS)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:GUEVARRA
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 1:955 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1308
Mailing Address - Country:US
Mailing Address - Phone:530-893-5334
Mailing Address - Fax:530-893-2841
Practice Address - Street 1:955 EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1308
Practice Address - Country:US
Practice Address - Phone:530-893-5334
Practice Address - Fax:530-893-2841
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist