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NPI 1780809566

NPI 1780809566 : DOUGLAS DEAN MCGUIRE DMD : CLIFTON, NJ

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General NPI Number Information
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    NPI Number           |    1780809566
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    Entity Type          |    Individual 
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    Provider Name        |    DOUGLAS DEAN MCGUIRE DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/16/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    721 CLIFTON AVE 
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    City                 |    CLIFTON
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    State                |    NJ
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    Zip                  |    07013-1880
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    Country              |    US
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    Telephone            |    973-779-6995
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    Fax                  |    973-779-7884
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Provider Business Mailing Address
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    Address Line         |    49 WARE RD 
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    City                 |    UPPER SADDLE RIVER
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    State                |    NJ
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    Zip                  |    07458-1925
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    Country              |    US
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    Telephone            |    201-327-1577
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    Fax                  |    973-779-7884
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    22DI01256700
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    License Number State |    NJ
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