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1720207673
IVAN MCKINNEY
TYLER, TX
NPI
1720207673
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: TX 10724)
Enumeration Date
2007-04-25
Last Update Date
2008-06-12
Business Address
-- IVAN MCKINNEY DDS
3802 BROOKSIDE DR
TYLER, TX 75701-9420
Phone number: 903-581-0581
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Mailing Address
-- IVAN MCKINNEY DDS
3802 BROOKSIDE DR
TYLER, TX 75701-9420
Phone number: 903-581-0581
Copy
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