Provider Demographics
NPI:1952094104
Name:SUAREZ GUERRA, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:SUAREZ GUERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 VALLEY MNR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2252
Mailing Address - Country:US
Mailing Address - Phone:786-488-8403
Mailing Address - Fax:
Practice Address - Street 1:6735 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-3039
Practice Address - Country:US
Practice Address - Phone:205-810-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD007327C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist