# JACKIE N. WYLAND

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- **Entity:** Organization
- **Status:** Active
- **Other names:** McKee Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841462462
- **Authorized official:** MR. JACKIE NELSON WYLAND (OWNER)
- **Authorized official phone:** (814) 695-1801

## Contact information

- **Practice address:** RD 1 BOX 147 A, DEVECCHIS ST MCKEE, EAST FREEDOM, PA 16637
- **Practice address phone:** (814) 695-1801
- **Mailing address:** RD 1 BOX 147 A, EAST FREEDOM, PA 16637-9731
- **Mailing address phone:** (814) 695-1801
- **Mailing address fax:** (814) 695-7074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS021195L | PA | Yes |

## Other

- **Enumeration date:** 03/25/2008
- **Last updated:** 07/31/2008