Provider Demographics
NPI:1689787608
Name:GUTTRY, ROBERT BYRON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BYRON
Last Name:GUTTRY
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 1:903 JUDSON RD
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5114
Mailing Address - Country:US
Mailing Address - Phone:903-758-0189
Mailing Address - Fax:903-758-7970
Practice Address - Street 1:903 JUDSON RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5114
Practice Address - Country:US
Practice Address - Phone:903-758-0189
Practice Address - Fax:903-758-7970
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA189461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice