Individual
DR. PAUL MICHAEL MCLEOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
919 E JEFFERSON BLVD STE LL02, SOUTH BEND, IN 46617-3119
(574) 233-7331
(574) 233-3434
Mailing address
919 E JEFFERSON BLVD STE LL02, SOUTH BEND, IN 46617-3119
(574) 233-7331
(574) 233-3434
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12009809A
IN
1223G0001X
General Practice Dentistry
Primary
1223G0001X
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200091260A
—
IN
Enumeration date
02/20/2008
Last updated
02/20/2008
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