Provider Demographics
NPI:1447475975
Name:GUEVARA, PETER A (DMD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:GUEVARA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9102 BABCOCK BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237
Mailing Address - Country:US
Mailing Address - Phone:412-367-3390
Mailing Address - Fax:412-367-3469
Practice Address - Street 1:9102 BABCOCK BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-367-3390
Practice Address - Fax:412-367-3469
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020848L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics