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General NPI Number Information
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NPI Number | 1760516785
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Entity Type | Individual
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Provider Name | THOMAS ROBERT MCCLELLAND D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 157 ROCKAWAY AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-1429
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Country | US
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Telephone | 516-746-4510
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Fax | 516-746-4510
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Provider Business Mailing Address
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Address Line | 178 BROMPTON RD
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City | GARDEN CITY
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State | NY
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Zip | 11530-1432
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Country | US
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Telephone | 516-747-6281
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Fax | 516-746-4510
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 32539
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License Number State | NY
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