Provider Demographics
NPI:1780809566
Name:MCGUIRE, DOUGLAS DEAN (DMD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:DEAN
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:DOUGLAS
Other - Middle Name:DEAN
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:49 WARE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1925
Mailing Address - Country:US
Mailing Address - Phone:201-327-1577
Mailing Address - Fax:973-779-7884
Practice Address - Street 1:721 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1880
Practice Address - Country:US
Practice Address - Phone:973-779-6995
Practice Address - Fax:973-779-7884
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI012567001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice