Individual
MICHAEL JUSTICE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3555 E US-412 HWY, SUITE 30, SILOAM SPRINGS, AR 72761
(210) 956-0517
Mailing address
2817 COUNTRY VALLEY RD, GARLAND, TX 75043-1121
(425) 457-9182
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
35763
TX
1223G0001X
General Practice Dentistry
Primary
4632
AR
1223G0001X
General Practice Dentistry
LL463-18
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2018
Last updated
11/16/2022
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