Provider Demographics
NPI:1023204583
Name:GUYTON, SALLY A (DDS)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:A
Last Name:GUYTON
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 1:1319 W BASELINE RD
Mailing Address - Street 2:#200
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9307
Mailing Address - Country:US
Mailing Address - Phone:303-664-5775
Mailing Address - Fax:303-664-5774
Practice Address - Street 1:1319 W BASELINE RD
Practice Address - Street 2:#200
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-9307
Practice Address - Country:US
Practice Address - Phone:303-664-5775
Practice Address - Fax:303-664-5774
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8544122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist