Healthcare Provider Details

I. General information

NPI: 1619916467
Provider Name (Legal Business Name): RICHARD PAUL MCCLAIN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 MAIN ST
BENTLEYVILLE PA
15314-1553
US

IV. Provider business mailing address

1728 S SHORE CT
PITTSBURGH PA
15203-1573
US

V. Phone/Fax

Practice location:
  • Phone: 724-239-5100
  • Fax: 724-239-5188
Mailing address:
  • Phone: 412-481-0866
  • Fax: 412-481-0865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS019596-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: