Provider Demographics
NPI:1538683180
Name:ARRECHEA, GUSTAVO C (DDS)
Entity Type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:C
Last Name:ARRECHEA
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 1:3501 N MACARTHUR BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3649
Mailing Address - Country:US
Mailing Address - Phone:972-546-4114
Mailing Address - Fax:
Practice Address - Street 1:3501 N MACARTHUR BLVD STE 410
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3649
Practice Address - Country:US
Practice Address - Phone:972-546-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice