Individual
MICHAEL LEE MCCUNNIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1350 SE UNIVERSITY AVE, WAUKEE, IA 50263-8933
(319) 939-4105
Mailing address
142 SW 2ND ST, CORVALLIS, OR 97333-4716
(888) 468-0022
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DDS-09490
IA
1223G0001X
General Practice Dentistry
D10504
OR
Other
Enumeration date
07/25/2016
Last updated
06/02/2022
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