Provider Demographics
NPI:1871568840
Name:MCGHEE, STANLEY WATSON (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:WATSON
Last Name:MCGHEE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WESTCHESTER AVE.
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4060
Mailing Address - Country:US
Mailing Address - Phone:410-744-6185
Mailing Address - Fax:410-744-0831
Practice Address - Street 1:1009 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-5055
Practice Address - Country:US
Practice Address - Phone:410-744-7610
Practice Address - Fax:410-744-0831
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD45021223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT59449Medicare UPIN
MD273L523BMedicare ID - Type Unspecified