Provider Demographics
NPI:1790559821
Name:MCGUIRE, AMY LYNN (RDH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:PUTNAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:1 CUMBERLAND ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-974-8452
Mailing Address - Fax:
Practice Address - Street 1:1 CUMBERLAND ST
Practice Address - Street 2:SUITE 116
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-974-3018
Practice Address - Fax:207-974-3067
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH2810124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist