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General NPI Number Information
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NPI Number | 1760834626
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Entity Type | Individual
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Provider Name | KAITLIN MCCANN D.M.D
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Gender | Female
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Dates
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Enumeration Date | 07/04/2016
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Last Update Date | 07/04/2016
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Provider Practice Location Address
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Address Line | 9500 MENTOR AVE 280
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City | MENTOR
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State | OH
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Zip | 44060-8713
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Country | US
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Telephone | 440-352-2887
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Fax |
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Provider Business Mailing Address
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Address Line | 2223 GLOUCHESTER DR
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City | LYNDHURST
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State | OH
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Zip | 44124-4012
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Country | US
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Telephone | 216-903-3202
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Fax |
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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 | 30.24755
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License Number State | OH
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