Provider Demographics
NPI:1659646123
Name:ARNEL DE GUZMAN, DDS INC.
Entity Type:Organization
Organization Name:ARNEL DE GUZMAN, DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARNEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-600-7112
Mailing Address - Street 1:17885 MAPLEHURST PL
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-6396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24148 LYONS AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2442
Practice Address - Country:US
Practice Address - Phone:661-888-4980
Practice Address - Fax:661-370-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52847122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty