Provider Demographics
NPI:1235440108
Name:GUZMAN DENTAL PARTNERS OF BOSTON, PLLC
Entity Type:Organization
Organization Name:GUZMAN DENTAL PARTNERS OF BOSTON, PLLC
Other - Org Name:DENTAL PARTNERS OF BOSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:617-259-1100
Mailing Address - Street 1:800 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02199-8001
Mailing Address - Country:US
Mailing Address - Phone:617-259-1100
Mailing Address - Fax:
Practice Address - Street 1:800 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-8001
Practice Address - Country:US
Practice Address - Phone:617-259-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN20823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty