Provider Demographics
NPI:1568620813
Name:MCGUFFIE, AXEL E (DMD)
Entity Type:Individual
Prefix:DR
First Name:AXEL
Middle Name:E
Last Name:MCGUFFIE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21073 POWERLINE RD STE 65
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2306
Mailing Address - Country:US
Mailing Address - Phone:561-235-5424
Mailing Address - Fax:
Practice Address - Street 1:21073 POWERLINE RD STE 65
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2306
Practice Address - Country:US
Practice Address - Phone:561-235-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN151071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice