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General NPI Number Information
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NPI Number | 1336651561
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Entity Type | Organization
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Legal Business Name | JONATHAN MCEWEN DDS, PLLC
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 10/27/2017
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Provider Practice Location Address
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Address Line | 20212 CHAMPION FOREST DR STE 400
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City | SPRING
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State | TX
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Zip | 77379-8698
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Country | US
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Telephone | 832-303-5414
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Fax |
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Provider Business Mailing Address
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Address Line | 9318 STRATFORD PL
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City | TOMBALL
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State | TX
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Zip | 77375-4299
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Country | US
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Telephone | 281-210-7079
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JONATHAN PATRICK MCEWEN
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Credential | DDS
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Telephone | 281-210-7079
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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 | 24701
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License Number State | TX
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