Provider Demographics
NPI:1083624852
Name:NASH, GUY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:R
Last Name:NASH
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 1:29740 RANCHO CALIFORNIA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5287
Mailing Address - Country:US
Mailing Address - Phone:951-699-0700
Mailing Address - Fax:951-699-7728
Practice Address - Street 1:29740 RANCHO CALIFORNIA RD
Practice Address - Street 2:STE 100
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5200
Practice Address - Country:US
Practice Address - Phone:951-699-0700
Practice Address - Fax:951-699-7728
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0319601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice