Provider Demographics
NPI:1164743191
Name:GUY, MOLLY LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:LYNN
Last Name:GUY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 VALLEYGATE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3688
Mailing Address - Country:US
Mailing Address - Phone:910-485-8884
Mailing Address - Fax:910-485-8782
Practice Address - Street 1:2015 VALLEYGATE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3757
Practice Address - Country:US
Practice Address - Phone:910-485-7070
Practice Address - Fax:910-485-1151
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice