Provider Demographics
NPI:1740382985
Name:NOROUZI, GUILAN (DDS)
Entity Type:Individual
Prefix:
First Name:GUILAN
Middle Name:
Last Name:NOROUZI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7934 N LINDBERGH BLVD
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042
Mailing Address - Country:US
Mailing Address - Phone:314-831-8086
Mailing Address - Fax:314-831-9563
Practice Address - Street 1:7934 N LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042
Practice Address - Country:US
Practice Address - Phone:314-831-8086
Practice Address - Fax:314-831-9563
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO014151122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist