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NPI Code Detail

MEDICARE: DR. DANIEL SCOTT MCCLURE D.D.S.

MEDICARE: DR. DANIEL SCOTT MCCLURE D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry15603OH

General Provider Information

NPI Number : 1124011598
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL SCOTT MCCLURE D.D.S.
Provider Business Mailing Address
First Line : 5439 BURKHARDT RD
Second Line :
City : DAYTON
State : OH
Zip : 45431-2111
Country : US
Telephone Number : 937-256-9606
Fax Number :
Provider Business Practice Location Address
First Line : 5439 BURKHARDT RD
Second Line :
City : DAYTON
State : OH
Zip : 45431-2111
Country : US
Telephone Number : 937-256-9606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/08/2007

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