Provider Demographics
NPI:1346453479
Name:GUERRA, JUAN CARLOS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:GUERRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 N FM 3167
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6211
Mailing Address - Country:US
Mailing Address - Phone:956-487-4746
Mailing Address - Fax:956-487-4468
Practice Address - Street 1:127 N FM 3167
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6211
Practice Address - Country:US
Practice Address - Phone:956-263-1889
Practice Address - Fax:956-263-1943
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110318011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice