Individual
AIDAN MCKINLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
554 KEILY STREET, BUREAU OF MED AND SURGERY -CREDENTIALING, JACKSONVILLE, FL 32212
(757) 953-7011
Mailing address
554 KEILY STREET, BUREAU OF MED AND SURGERY -CREDENTIALING, JACKSONVILLE, FL 32212
(757) 953-7011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401415005
VA
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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