Provider Demographics
NPI:1619405206
Name:GUIO, EDGAR G (DDS)
Entity type:Individual
Prefix:MR
First Name:EDGAR
Middle Name:G
Last Name:GUIO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 GRAND CANAL
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1886
Mailing Address - Country:US
Mailing Address - Phone:949-630-6012
Mailing Address - Fax:
Practice Address - Street 1:10750 GLENOAKS BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-7276
Practice Address - Country:US
Practice Address - Phone:818-686-1400
Practice Address - Fax:818-686-1411
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA652251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice