Healthcare Provider Details

I. General information

NPI: 1124934153
Provider Name (Legal Business Name): MCCARTY DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 W NEPESSING ST
LAPEER MI
48446-2144
US

IV. Provider business mailing address

PO BOX 74
CLARKSTON MI
48347-0074
US

V. Phone/Fax

Practice location:
  • Phone: 248-421-8918
  • Fax:
Mailing address:
  • Phone: 248-421-8918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER MCCARTY
Title or Position: CEO
Credential: DDS
Phone: 248-421-8918