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General NPI Number Information
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NPI Number | 1821174293
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Entity Type | Organization
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Legal Business Name | MICHAEL P. MCCLAIN, D.M.D., PC
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Dates
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Enumeration Date | 10/28/2006
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 1405 E WOOD ST
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City | PARIS
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State | TN
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Zip | 38242-5655
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Country | US
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Telephone | 731-644-9311
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Fax | 731-644-9313
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Provider Business Mailing Address
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Address Line | 1405 E WOOD ST
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City | PARIS
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State | TN
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Zip | 38242-5655
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Country | US
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Telephone | 731-644-9311
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Fax | 731-644-9313
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. MICHAEL PICKARD MCCLAIN
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Credential | D.M.D.
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Telephone | 731-644-9311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS0000004307
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License Number State | TN
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