Provider Demographics
NPI:1396463857
Name:MCGUIRT, HALEY ALEXIS (STUDENT (DMD))
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ALEXIS
Last Name:MCGUIRT
Suffix:
Gender:F
Credentials:STUDENT (DMD)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6703 HAWKSNEST LN
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-9702
Mailing Address - Country:US
Mailing Address - Phone:704-576-9894
Mailing Address - Fax:
Practice Address - Street 1:6703 HAWKSNEST LN
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:NC
Practice Address - Zip Code:28164-9702
Practice Address - Country:US
Practice Address - Phone:704-576-9894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program