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NPI Code Detail

MEDICARE: DR. GERALD F MCCANN D.D.S., M.S.D.

MEDICARE:  DR. GERALD F MCCANN  D.D.S., M.S.D.
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
11223E0200XEndodontics4517WA

General Provider Information

NPI Number : 1669507497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD F MCCANN D.D.S., M.S.D.
Provider Business Mailing Address
First Line : 24 EVERGREEN LN
Second Line :
City : MERCER ISLAND
State : WA
Zip : 98040-3910
Country : US
Telephone Number : 206-232-2999
Fax Number :
Provider Business Practice Location Address
First Line : 9714 3RD AVE NE
Second Line : SUITE 203
City : SEATTLE
State : WA
Zip : 98115-2044
Country : US
Telephone Number : 206-525-1515
Fax Number : 206-524-1014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/08/2007

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Directions to “ DR. GERALD F MCCANN D.D.S., M.S.D.” Practice Location

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