Provider Demographics
NPI:1629189303
Name:MCGUIRE, TAYLOR P (DDS)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:P
Last Name:MCGUIRE
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 1:875 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-1935
Mailing Address - Country:US
Mailing Address - Phone:901-448-6233
Mailing Address - Fax:901-448-5480
Practice Address - Street 1:875 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-1935
Practice Address - Country:US
Practice Address - Phone:901-448-6233
Practice Address - Fax:901-448-5480
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPRV-FP-096-061223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery