Individual
MS. BREANNA LORRAINE MCCOY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1100 SOUTHGATE STE 17, PENDLETON, OR 97801-3971
(541) 276-1561
(541) 276-5743
Mailing address
2807 N DEPOT ST, LA GRANDE, OR 97850-3131
(541) 963-8970
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5193
OR
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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