Provider Demographics
NPI:1366633026
Name:MCGARVEY, MICHAEL JUDE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JUDE
Last Name:MCGARVEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4868 BRECKENRIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-1341
Mailing Address - Country:US
Mailing Address - Phone:315-430-6184
Mailing Address - Fax:
Practice Address - Street 1:578 SENECA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2600
Practice Address - Country:US
Practice Address - Phone:315-606-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0454031223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics