Provider Demographics
NPI:1740380328
Name:GUINTA, WILLIAM CARL (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CARL
Last Name:GUINTA
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:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-0367
Mailing Address - Country:US
Mailing Address - Phone:815-485-3449
Mailing Address - Fax:815-485-4482
Practice Address - Street 1:600 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1931
Practice Address - Country:US
Practice Address - Phone:815-485-3449
Practice Address - Fax:815-485-4482
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL154891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice