Organization
RAY N MCKINLEY DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY NELSON MCKINLEY DDS (PRESIDENT)
(586) 685-0880
Entity
Organization
Contact information
Practice address
45665 VILLAGE BLVD, SHELBY TWP, MI 48315-6068
(586) 685-0880
(586) 685-0885
Mailing address
45665 VILLAGE BLVD, SHELBY TWP, MI 48315-6068
(586) 685-0880
(586) 685-0885
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D10907
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TYPE 1 NPI
1730211939
MI
Enumeration date
09/27/2012
Last updated
09/27/2012
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