Provider Demographics
NPI:1861713315
Name:GUEVARRA, MARIA A (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:GUEVARRA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:29955 TECHNOLOGY DR
Mailing Address - Street 2:STE C-102
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2637
Mailing Address - Country:US
Mailing Address - Phone:951-894-1934
Mailing Address - Fax:951-894-1936
Practice Address - Street 1:29955 TECHNOLOGY DR
Practice Address - Street 2:STE C-102
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2637
Practice Address - Country:US
Practice Address - Phone:951-894-1934
Practice Address - Fax:951-894-1936
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA482781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice