Provider Demographics
NPI:1225265127
Name:GUERECA, SANDRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:GUERECA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23630 CARLSON CT
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4583
Mailing Address - Country:US
Mailing Address - Phone:510-728-9842
Mailing Address - Fax:510-887-2872
Practice Address - Street 1:24901 SANTA CLARA ST
Practice Address - Street 2:STE B2
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-2147
Practice Address - Country:US
Practice Address - Phone:510-887-6835
Practice Address - Fax:510-887-2872
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA537941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice