Provider Demographics
NPI:1700235314
Name:GUILD, TATE (DMD)
Entity Type:Individual
Prefix:
First Name:TATE
Middle Name:
Last Name:GUILD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 W CHARLESTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1965
Mailing Address - Country:US
Mailing Address - Phone:702-877-6608
Mailing Address - Fax:702-877-0038
Practice Address - Street 1:2801 W CHARLESTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1965
Practice Address - Country:US
Practice Address - Phone:702-877-6608
Practice Address - Fax:702-877-0038
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist