NPI | 1457551483 |
---|---|
Former Legal Business Name | MCCOY DENTAL CLINIC |
Entity Type | Organization |
Authorized Contact | ROLFE C MCCOY CEO 660-646-3802 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2007-07-18 |
Last Update Date | 2019-02-18 |