Provider Demographics
NPI:1841472628
Name:PHILIP G. MAGUIRE D.D.S. PLLC
Entity type:Organization
Organization Name:PHILIP G. MAGUIRE D.D.S. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-525-0868
Mailing Address - Street 1:2211 NW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8804
Mailing Address - Country:US
Mailing Address - Phone:405-525-0868
Mailing Address - Fax:
Practice Address - Street 1:2211 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8804
Practice Address - Country:US
Practice Address - Phone:405-525-0868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4791261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental