Provider Demographics
NPI:1326337817
Name:RICHARD P. GUSILATAR DDS APC
Entity Type:Organization
Organization Name:RICHARD P. GUSILATAR DDS APC
Other - Org Name:PLEASANT SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PENAMANTE
Authorized Official - Last Name:GUSILATAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-641-2323
Mailing Address - Street 1:19749 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2623
Mailing Address - Country:US
Mailing Address - Phone:818-887-8900
Mailing Address - Fax:818-887-8976
Practice Address - Street 1:19749 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2623
Practice Address - Country:US
Practice Address - Phone:818-887-8900
Practice Address - Fax:818-887-8976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty