Individual
DR. JEFFREY S MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
117 S NAPPANEE ST, ELKHART, IN 46514-1955
(574) 293-8211
(574) 295-8270
Mailing address
117 S NAPPANEE ST, ELKHART, IN 46514-1955
(574) 293-8211
(574) 295-8270
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12008926
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083627
ANTHEM PROVIDER #
IN
Enumeration date
10/11/2006
Last updated
12/12/2011
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