Provider Demographics
NPI:1659397735
Name:GUERRERO, JEANETTE CRUZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:CRUZ
Last Name:GUERRERO
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 1:31857 ALVARADO BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3912
Mailing Address - Country:US
Mailing Address - Phone:510-441-2952
Mailing Address - Fax:510-441-2903
Practice Address - Street 1:31857 ALVARADO BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3912
Practice Address - Country:US
Practice Address - Phone:510-441-2952
Practice Address - Fax:510-441-2903
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice