Provider Demographics
NPI:1881096378
Name:AILEEN ARCE DE GUZMAN
Entity type:Organization
Organization Name:AILEEN ARCE DE GUZMAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:ARCE
Authorized Official - Last Name:DE GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-475-5767
Mailing Address - Street 1:2240 EAST PLAZA BLVD.
Mailing Address - Street 2:SUITE Q
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-5166
Mailing Address - Country:US
Mailing Address - Phone:619-475-5767
Mailing Address - Fax:619-475-5417
Practice Address - Street 1:2240 EAST PLAZA BLVD
Practice Address - Street 2:SUITE Q
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5166
Practice Address - Country:US
Practice Address - Phone:619-475-5767
Practice Address - Fax:619-475-5417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA478431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty