Provider Demographics
NPI:1861515751
Name:MAGUDA, DAVID F (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:F
Last Name:MAGUDA
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 1:24151 W GREYSTONE LN
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98020-5227
Mailing Address - Country:US
Mailing Address - Phone:206-533-1379
Mailing Address - Fax:
Practice Address - Street 1:9714 3RD AVE NE
Practice Address - Street 2:#201
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2044
Practice Address - Country:US
Practice Address - Phone:206-522-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000055931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice