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NPI 1952900466

NPI 1952900466 : GWENDOLYN KINES-MCLEOD DDS,PLLC : TERRELL, TX

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General NPI Number Information
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    NPI Number           |    1952900466
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    Entity Type          |    Organization 
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    Legal Business Name  |    GWENDOLYN KINES-MCLEOD DDS,PLLC 
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Dates
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    Enumeration Date     |    10/26/2020
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    Last Update Date     |    10/26/2020
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Provider Practice Location Address
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    Address Line         |    401 N ANN ST STE B 
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    City                 |    TERRELL
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    State                |    TX
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    Zip                  |    75160-2549
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    Country              |    US
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    Telephone            |    972-524-5347
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    Fax                  |    972-524-2142
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Provider Business Mailing Address
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    Address Line         |    401 N ANN ST STE B 
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    City                 |    TERRELL
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    State                |    TX
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    Zip                  |    75160-2549
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    Country              |    US
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    Telephone            |    972-524-5347
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    Fax                  |    972-524-2142
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Authorized Official
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    Title or Position    |    DENTIST
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    Name                 |    DR. GWENDOLYN KINES MCLEOD 
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    Credential           |    DDS
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    Telephone            |    972-524-5347
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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       |    
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    License Number State |    
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