Provider Demographics
NPI:1205022860
Name:WILLIAM GUTH DDS
Entity type:Organization
Organization Name:WILLIAM GUTH DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTORS
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:GUTH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:928-634-9366
Mailing Address - Street 1:322 S MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-3693
Mailing Address - Country:US
Mailing Address - Phone:928-634-9366
Mailing Address - Fax:938-634-8991
Practice Address - Street 1:322 S MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3693
Practice Address - Country:US
Practice Address - Phone:928-634-9366
Practice Address - Fax:938-634-8991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty