Provider Demographics
NPI:1285764480
Name:MCGUIRE, RICHARDSON L (DDS, MSD)
Entity type:Individual
Prefix:
First Name:RICHARDSON
Middle Name:L
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 N. MOPAC EXPRESSWAY
Mailing Address - Street 2:BLDG 2 SUITE 2207
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3286
Mailing Address - Country:US
Mailing Address - Phone:512-452-7668
Mailing Address - Fax:512-452-7663
Practice Address - Street 1:6500 N. MOPAC EXPRESSWAY
Practice Address - Street 2:BUILDING 2 SUITE 2207
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3286
Practice Address - Country:US
Practice Address - Phone:512-452-7668
Practice Address - Fax:512-452-7663
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX224001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics