Provider Demographics
NPI:1659824860
Name:MCGUIRE, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
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 1:5095 RIFLE RIVER TRL
Mailing Address - Street 2:
Mailing Address - City:ALGER
Mailing Address - State:MI
Mailing Address - Zip Code:48610-9327
Mailing Address - Country:US
Mailing Address - Phone:989-873-5152
Mailing Address - Fax:
Practice Address - Street 1:2255 TWINING RD
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:MI
Practice Address - Zip Code:48765-9707
Practice Address - Country:US
Practice Address - Phone:989-873-5152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902017646124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist