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Individual
DR. KEITH M MCCLUNG
Active
Individual
DR. KEITH M MCCLUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2355
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0410
DELTA DENTAL
NJ
01
—
101964
UCCI
PA
01
—
3122554
BCBS
TN
01
—
5751202
AETNA
—
01
—
58746
BCBS
AR
Enumeration date
01/17/2007
Last updated
07/08/2007
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