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Individual

DR. JUDITH WILLETT MCGUIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
875 UNION AVE, MEMPHIS, TN 38103-3513
(901) 448-6204
(901) 448-1371
Mailing address
1966 TUTWILER AVE, MEMPHIS, TN 38107-5126
(901) 692-7586
(901) 278-4645

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9036
TN
1223G0001X
General Practice Dentistry
008712
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
308316
UTHSC EMPLOYEE NUMBER
TN
01
8712
DENTAL LICENSE
GA
01
9033
DENTAL LICENSE
TN
Enumeration date
07/27/2006
Last updated
08/18/2015
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