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General NPI Number Information
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NPI Number | 1174202550
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Entity Type | Organization
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Legal Business Name | MARIA T MCMULLIN DDS PLLC
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 116 COLE RD
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City | MONROE
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State | MI
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Zip | 48162-4104
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Country | US
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Telephone | 734-868-5115
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 W STEIN RD
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City | LA SALLE
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State | MI
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Zip | 48145-9799
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Country | US
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Telephone | 734-625-6967
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA T MCMULLIN
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Credential | DDS
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Telephone | 734-241-5115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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