Provider Demographics
NPI:1316191794
Name:RAPHAEL GUERRA D.D.S
Entity Type:Organization
Organization Name:RAPHAEL GUERRA D.D.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-673-1561
Mailing Address - Street 1:7318 MILITARY DR W
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-2947
Mailing Address - Country:US
Mailing Address - Phone:210-673-1561
Mailing Address - Fax:210-675-7568
Practice Address - Street 1:7318 MILITARY DR W
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-2947
Practice Address - Country:US
Practice Address - Phone:210-673-1561
Practice Address - Fax:210-675-7568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14056122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty