Provider Demographics
NPI:1346071578
Name:GUY, ALICIA SHERISE (DDS)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:SHERISE
Last Name:GUY
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 OLD HICKORY BLVD APT 325
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5254
Mailing Address - Country:US
Mailing Address - Phone:901-230-6286
Mailing Address - Fax:
Practice Address - Street 1:1386 GRAY HWY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-1952
Practice Address - Country:US
Practice Address - Phone:478-992-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1237161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice