Provider Demographics
NPI:1992852644
Name:JOSHUA RYAN GUIDRY DDS & ASSOCIATES
Entity Type:Organization
Organization Name:JOSHUA RYAN GUIDRY DDS & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-449-0611
Mailing Address - Street 1:556 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3506
Mailing Address - Country:US
Mailing Address - Phone:985-449-0611
Mailing Address - Fax:985-449-0613
Practice Address - Street 1:556 CARDINAL DR
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3506
Practice Address - Country:US
Practice Address - Phone:985-449-0611
Practice Address - Fax:985-449-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty