Individual
DR. KEVIN MARTIN MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
719 17TH ST, JACKSON, MI 49203-1409
(517) 782-2439
Mailing address
1846 W HENDERSON ST, CHICAGO, IL 60657-2015
(773) 286-5935
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901017848
MI
Other
Enumeration date
05/24/2007
Last updated
07/09/2007
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