Provider Demographics
NPI:1023653557
Name:MCNUMB DENTAL PC
Entity type:Organization
Organization Name:MCNUMB DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:404-254-1128
Mailing Address - Street 1:1441 DRESDEN DR NE STE 250
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3585
Mailing Address - Country:US
Mailing Address - Phone:404-254-1128
Mailing Address - Fax:
Practice Address - Street 1:1441 DRESDEN DR NE STE 250
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3585
Practice Address - Country:US
Practice Address - Phone:404-254-1128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty