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General NPI Number Information
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NPI Number | 1255542098
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Entity Type | Organization
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Legal Business Name | KYLE WAYNE MCCRACKEN, DDS, PA
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 5509 PLEASANT VALLEY DR SUITE 90
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City | PLANO
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State | TX
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Zip | 75023-5248
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Country | US
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Telephone | 972-596-1503
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 ARGYLE DR
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City | PLANO
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State | TX
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Zip | 75023-5229
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Country | US
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Telephone | 214-725-1302
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYLE WAYNE MCCRACKEN
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Credential | DDS
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Telephone | 972-596-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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