Provider Demographics
NPI:1093373060
Name:GUZAK, ERIC (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:GUZAK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-1869
Mailing Address - Country:US
Mailing Address - Phone:614-442-3933
Mailing Address - Fax:614-442-3932
Practice Address - Street 1:1895 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-1869
Practice Address - Country:US
Practice Address - Phone:614-442-3933
Practice Address - Fax:614-442-3932
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300258261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
1376755207OtherDELTA DENTAL, METLIFE, AETNA