Provider Demographics
NPI:1033361928
Name:MCLEAN, ROBERT M (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:MCLEAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 THE EXCHANGE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339
Mailing Address - Country:US
Mailing Address - Phone:770-980-0232
Mailing Address - Fax:770-952-8806
Practice Address - Street 1:1820 THE EXCHANGE
Practice Address - Street 2:SUITE 700
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:770-980-0232
Practice Address - Fax:770-952-8806
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice