Provider Demographics
NPI:1366698904
Name:MCGRORY, JOHN KEVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KEVIN
Last Name:MCGRORY
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:135 OYSTER CREEK DR
Mailing Address - Street 2:# U
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4183
Mailing Address - Country:US
Mailing Address - Phone:979-297-4059
Mailing Address - Fax:979-297-6115
Practice Address - Street 1:135 OYSTER CREEK DR
Practice Address - Street 2:# U
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4183
Practice Address - Country:US
Practice Address - Phone:979-297-4059
Practice Address - Fax:979-297-6115
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX228361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics