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General NPI Number Information
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NPI Number | 1356606461
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Entity Type | Organization
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Legal Business Name | MCLAIN SURGICAL ARTS
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Dates
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Enumeration Date | 07/05/2012
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 2045 CECIL ASHBURN DR SE SUITE 101
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City | HUNTSVILLE
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State | AL
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Zip | 35802-2563
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Country | US
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Telephone | 256-429-3411
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Fax | 256-429-3413
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Provider Business Mailing Address
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Address Line | 2045 CECIL ASHBURN DR SE SUITE 101
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City | HUNTSVILLE
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State | AL
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Zip | 35802-2563
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Country | US
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Telephone | 256-429-3411
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Fax | 256-429-3413
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Authorized Official
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Title or Position | SURGEON
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Name | LANDON MCLAIN
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Credential | MD, DMD
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Telephone | 256-429-3411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 5212
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 28817
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License Number State | AL
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