Provider Demographics
NPI:1346368032
Name:DE GUZMAN, MARIA TERESA RAMOS (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA TERESA
Middle Name:RAMOS
Last Name:DE GUZMAN
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 1:5060 SUNRISE BLVD
Mailing Address - Street 2:SUITE A5
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4944
Mailing Address - Country:US
Mailing Address - Phone:916-863-0456
Mailing Address - Fax:
Practice Address - Street 1:5060 SUNRISE BLVD
Practice Address - Street 2:SUITE A5
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4944
Practice Address - Country:US
Practice Address - Phone:916-863-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice