Provider Demographics
NPI:1841773421
Name:GUZMAN, OSCAR (RDHAP)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 COZUMEL
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-4461
Mailing Address - Country:US
Mailing Address - Phone:949-929-8084
Mailing Address - Fax:
Practice Address - Street 1:302 COZUMEL
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-4461
Practice Address - Country:US
Practice Address - Phone:949-929-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28313124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist