MEDICARE: DR. NATOYA MCLEAN 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
1	1223G0001X	General Practice Dentistry	DN17302	FL

General Provider Information

NPI Number	:	1073645271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATOYA MCLEAN DDS

Provider Business Mailing Address
First Line	:	1912 W REYNOLDS ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-4700
Country	:	US
Telephone Number	:	813-567-7001
Fax Number	:	813-567-7006

Provider Business Practice Location Address
First Line	:	1912 W REYNOLDS ST
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563
Country	:	US
Telephone Number	:	813-567-7001
Fax Number	:	813-567-7006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/14/2019

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