Healthcare Provider Details

I. General information

NPI: 1497834204
Provider Name (Legal Business Name): JOHN MCGUIRE D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 W MAIN ST
MORRISTOWN TN
37814-4632
US

IV. Provider business mailing address

301 GRANDEUR DR
KNOXVILLE TN
37920-6325
US

V. Phone/Fax

Practice location:
  • Phone: 423-318-8399
  • Fax: 423-318-8376
Mailing address:
  • Phone: 865-573-8499
  • Fax: 423-318-8376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDS3189
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: