Provider Demographics
NPI:1013387125
Name:PAUL J GUERRINO, DDS, PC
Entity Type:Organization
Organization Name:PAUL J GUERRINO, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUERRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-420-7083
Mailing Address - Street 1:400 E SANDFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-4725
Mailing Address - Country:US
Mailing Address - Phone:914-699-6568
Mailing Address - Fax:914-699-8140
Practice Address - Street 1:400 E SANDFORD BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-4725
Practice Address - Country:US
Practice Address - Phone:914-699-6568
Practice Address - Fax:914-699-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty