MEDICARE: DR. ARNOLD T MCCLAIN D.D.S., M.S.

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	1223P0300X	Periodontics	6920	NC

General Provider Information

NPI Number	:	1396941589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARNOLD T MCCLAIN D.D.S., M.S.

Provider Business Mailing Address
First Line	:	5015 SOUTHPARK DR
Second Line	:	SUITE 130
City	:	DURHAM
State	:	NC
Zip	:	27713-7736
Country	:	US
Telephone Number	:	919-484-8338
Fax Number	:	919-484-8308

Provider Business Practice Location Address
First Line	:	5015 SOUTHPARK DR
Second Line	:	SUITE 130
City	:	DURHAM
State	:	NC
Zip	:	27713-7736
Country	:	US
Telephone Number	:	919-484-8338
Fax Number	:	919-484-8308

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	07/08/2007

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