Provider Demographics
NPI:1366651911
Name:MARCO A GUERRERO DDS PC
Entity Type:Organization
Organization Name:MARCO A GUERRERO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-287-4623
Mailing Address - Street 1:518 N MORLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-2909
Mailing Address - Country:US
Mailing Address - Phone:520-287-4623
Mailing Address - Fax:520-287-4624
Practice Address - Street 1:518 N MORLEY AVE
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-2909
Practice Address - Country:US
Practice Address - Phone:520-287-4623
Practice Address - Fax:520-287-4624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ42321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty