Provider Demographics
NPI:1528460664
Name:GUERISOLI, CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:GUERISOLI
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 1:1345 GRAND AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1074
Mailing Address - Country:US
Mailing Address - Phone:510-654-6523
Mailing Address - Fax:510-420-8355
Practice Address - Street 1:1345 GRAND AVE STE 103
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:CA
Practice Address - Zip Code:94610-1074
Practice Address - Country:US
Practice Address - Phone:510-654-6523
Practice Address - Fax:510-420-8355
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63554122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist