MEDICARE: DR. DAVID PATRICK MCDONALD D.M.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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	7277	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689663692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID PATRICK MCDONALD D.M.D.

Provider Business Mailing Address
First Line	:	1720 GUNBARREL RD
Second Line	:	SUITE 200
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-3192
Country	:	US
Telephone Number	:	423-296-8905
Fax Number	:	423-296-8906

Provider Business Practice Location Address
First Line	:	1720 GUNBARREL RD
Second Line	:	SUITE 200
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-3192
Country	:	US
Telephone Number	:	423-296-8905
Fax Number	:	423-296-8906

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	12/07/2007

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