Provider Demographics
NPI:1356342174
Name:GUERRA, CATHERINE DIANE (DDS)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DIANE
Last Name:GUERRA
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 INTERQUEST PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-8333
Mailing Address - Country:US
Mailing Address - Phone:719-360-2403
Mailing Address - Fax:719-632-6283
Practice Address - Street 1:1359 INTERQUEST PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-8333
Practice Address - Country:US
Practice Address - Phone:719-374-5496
Practice Address - Fax:719-900-7795
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7212122300000X
CODEN.000072121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist