Provider Demographics
NPI:1790154847
Name:GUERRINO DENTISTRY, DDS, PC
Entity Type:Organization
Organization Name:GUERRINO DENTISTRY, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUERRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-420-7083
Mailing Address - Street 1:450 CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1078
Mailing Address - Country:US
Mailing Address - Phone:917-722-6500
Mailing Address - Fax:914-722-8395
Practice Address - Street 1:450 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1078
Practice Address - Country:US
Practice Address - Phone:917-722-6500
Practice Address - Fax:914-722-8395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty