Provider Demographics
NPI:1598828402
Name:GUARDINO, CHRISTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:GUARDINO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9736 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1311
Mailing Address - Country:US
Mailing Address - Phone:716-688-5717
Mailing Address - Fax:716-204-9028
Practice Address - Street 1:9736 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1311
Practice Address - Country:US
Practice Address - Phone:716-688-5717
Practice Address - Fax:716-204-9028
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040025-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice