Provider Demographics
NPI:1083109862
Name:MCGUIRE, RHONDA S
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:S
Last Name:MCGUIRE
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 1:3612 MEADOWDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-5716
Mailing Address - Country:US
Mailing Address - Phone:804-316-1267
Mailing Address - Fax:
Practice Address - Street 1:300 CENTRAL AVE BLDG 18036
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1526
Practice Address - Country:US
Practice Address - Phone:804-734-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA212705126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant