Individual
MR. GARY L. MCCORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
224 FRANKFORT ST, BROOKSVILLE, KY 41004-8306
(606) 735-3114
(606) 735-3114
Mailing address
P.O BOX 267, BROOKSVILLE, KY 41004
(606) 735-3114
(606) 735-3114
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5151
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60051513
—
KY
01
—
610980267
EMPLOYEE FEDERAL I.D
KY
Enumeration date
10/23/2006
Last updated
01/27/2015
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