Provider Demographics
NPI:1851407894
Name:GUERRIERI, JOHN ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:GUERRIERI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WALWORTH PENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WALWORTH
Mailing Address - State:NY
Mailing Address - Zip Code:14568
Mailing Address - Country:US
Mailing Address - Phone:315-986-1144
Mailing Address - Fax:315-986-9308
Practice Address - Street 1:2100 WALWORTH PENFIELD RD
Practice Address - Street 2:
Practice Address - City:WALWORTH
Practice Address - State:NY
Practice Address - Zip Code:14568
Practice Address - Country:US
Practice Address - Phone:315-986-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0457491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice