Provider Demographics
NPI:1841692860
Name:GUADALUPE QUEZADA DDS, INC.
Entity type:Organization
Organization Name:GUADALUPE QUEZADA DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUADALUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:QUEZADA D.D.S INC.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-562-8002
Mailing Address - Street 1:419 W HERMOSA ST
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247-1913
Mailing Address - Country:US
Mailing Address - Phone:559-562-8002
Mailing Address - Fax:559-562-4562
Practice Address - Street 1:419 W HERMOSA ST
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-1913
Practice Address - Country:US
Practice Address - Phone:559-562-8002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty