Individual
DR. KEITH M MCCLUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
221B HWY 463 N, SUITE B, TRUMAN, AR 72472
(870) 483-5011
(870) 483-7057
Mailing address
221B HWY 463 N, SUITE B, TRUMAN, AR 72472
(870) 483-5011
(870) 483-7057
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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