Individual
DR. JON M MCKINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
701 N RIVER ST, SPOONER, WI 54801-1311
(715) 635-8282
(715) 635-3994
Mailing address
701 N RIVER ST, SPOONER, WI 54801-1311
(715) 635-8282
(715) 635-3994
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5000443
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33667700
—
WI
01
—
769116
UNITED CONCORDIA
WI
Enumeration date
01/10/2007
Last updated
07/09/2007
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