Organization
MAC DENTAL
Active
Organization
MAC DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB MCLAUCHLIN (DENTIST)
(417) 725-3200
Entity
Organization
Contact information
Practice address
413 N MCCROSKEY ST, NIXA, MO 65714-9330
(417) 725-3200
Mailing address
413 N MCCROSKEY ST, NIXA, MO 65714-9330
(417) 725-3200
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
2013016358
MO
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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