Provider Demographics
NPI:1053813634
Name:DANIEL C. MCEOWEN DDS, PC
Entity Type:Organization
Organization Name:DANIEL C. MCEOWEN DDS, PC
Other - Org Name:DC MCEOWEN PERFECT SMILES, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MCEOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-432-6201
Mailing Address - Street 1:112 N MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713-1063
Mailing Address - Country:US
Mailing Address - Phone:301-432-6201
Mailing Address - Fax:
Practice Address - Street 1:112 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1063
Practice Address - Country:US
Practice Address - Phone:301-432-6201
Practice Address - Fax:301-432-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8715261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental