Provider Demographics
NPI:1366071532
Name:MCGUE, CHRISTOPHER ROBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:MCGUE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S CALUMET RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-3288
Mailing Address - Country:US
Mailing Address - Phone:219-921-1999
Mailing Address - Fax:
Practice Address - Street 1:700 S CALUMET RD STE 2
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-3288
Practice Address - Country:US
Practice Address - Phone:219-921-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
IN12013444A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program