Provider Demographics
NPI:1871507384
Name:GUZMAN, RIA MARCELINA (DDS)
Entity Type:Individual
Prefix:
First Name:RIA
Middle Name:MARCELINA
Last Name:GUZMAN
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 1:17612 BEACH BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6873
Mailing Address - Country:US
Mailing Address - Phone:714-843-6288
Mailing Address - Fax:714-843-6289
Practice Address - Street 1:17612 BEACH BLVD STE 1
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6873
Practice Address - Country:US
Practice Address - Phone:714-843-6288
Practice Address - Fax:714-843-6289
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA349651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice