Individual
DR. GARY EDWARD MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
424 N HIGH ST, MORRISTOWN, TN 37814-3863
(423) 581-1611
(423) 581-2045
Mailing address
1314 BALES DR, MORRISTOWN, TN 37814-6102
(423) 581-9248
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS0000001671
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3223266
—
TN
Enumeration date
10/19/2005
Last updated
08/01/2007
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