Susan Guirguis, DDS

Individual provider Active NPI General Practice Dentistry · Duluth, MN

NPI 1740346808 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1740346808
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D11559 (MN)
Practice address
2710 Piedmont Ave
Duluth, MN 55811-2936
Phone
(218) 525-5100
NPI assigned
Dec 30, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D11559MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Childrens Dental Care PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D11559 MN Yes

Addresses

Primary practice location

2710 Piedmont Ave
Duluth, MN 55811-2936

Mailing address

2710 Piedmont Ave
Duluth, MN 55811-2936
Phone (218) 525-5100

Other providers in Duluth, MN

All providers in Duluth, MN · General Practice Dentistry in Minnesota

Sources for this page

Verify at the official NPI Registry.