Provider Demographics
NPI:1790344406
Name:GUZMAN SUAREZ, LUIS GERARDO (DDS, MS, DMD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:GERARDO
Last Name:GUZMAN SUAREZ
Suffix:
Gender:M
Credentials:DDS, MS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 N COLLEGE ST STE D
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3030
Mailing Address - Country:US
Mailing Address - Phone:334-209-1352
Mailing Address - Fax:334-460-9728
Practice Address - Street 1:670 N COLLEGE ST STE D
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3030
Practice Address - Country:US
Practice Address - Phone:334-209-1352
Practice Address - Fax:334-460-9728
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00066251223P0700X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223P0700XDental ProvidersDentistProsthodontics