Individual
DR. MARY ELLEN MCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1011 N UNIVERSITY AVE, UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY, ANN ARBOR, MI 48109-1012
(734) 764-3155
(734) 615-4784
Mailing address
1011 N UNIVERSITY AVE, UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY, ANN ARBOR, MI 48109-1012
(734) 764-3155
(734) 615-4784
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901017144
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D171440
BCBS OF MI DENTAL
MI
Enumeration date
11/09/2006
Last updated
07/08/2007
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