Individual
MARIANNA J MCLEAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
128 ROSS ST, MOLALLA, OR 97038-9390
(503) 829-7567
(503) 829-3398
Mailing address
PO BOX 948, MOLALLA, OR 97038-0948
(503) 829-7567
(503) 829-3398
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5895
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126560
—
OR
Enumeration date
07/07/2005
Last updated
07/08/2007
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