Organization
MICHAEL E MCKENZIE JR, DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E MCKENZIE JR. DDS (DENTIST)
(573) 822-3107
Entity
Organization
Contact information
Practice address
2903 SAINT MARYS AVE, HANNIBAL, MO 63401-3714
(573) 822-3107
Mailing address
2903 SAINT MARYS AVE, HANNIBAL, MO 63401-3714
(573) 221-0440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2015017896
MO
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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