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NPI Code Detail

MEDICARE: MR. DENNIS MICHAEL MCCAFFREY DDS

MEDICARE: MR. DENNIS MICHAEL MCCAFFREY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12763MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1103430OTHERBLUE CROSS
2794816OTHERUNITED CONCORDIA

General Provider Information

NPI Number : 1073568135
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS MICHAEL MCCAFFREY DDS
Provider Business Mailing Address
First Line : PO BOX 360
Second Line :
City : CEDAR HILL
State : MO
Zip : 63016
Country : US
Telephone Number : 636-274-4272
Fax Number : 636-274-4224
Provider Business Practice Location Address
First Line : 6730 MALL DRIVE
Second Line :
City : CEDAR HILL
State : MO
Zip : 63016
Country : US
Telephone Number : 636-274-4272
Fax Number : 636-274-4224
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 07/08/2007

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