Provider Demographics
NPI:1821456062
Name:GUILLEMIN, CLAIRE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:
Last Name:GUILLEMIN
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 1:73211 FRED WARING DR STE 201
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2888
Mailing Address - Country:US
Mailing Address - Phone:323-834-8723
Mailing Address - Fax:
Practice Address - Street 1:73211 FRED WARING DR STE 201
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2888
Practice Address - Country:US
Practice Address - Phone:760-568-3368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1009221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice