Provider Demographics
NPI:1073645271
Name:MCLEAN, NATOYA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATOYA
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 W REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4700
Mailing Address - Country:US
Mailing Address - Phone:813-567-7001
Mailing Address - Fax:813-567-7006
Practice Address - Street 1:1912 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563
Practice Address - Country:US
Practice Address - Phone:813-567-7001
Practice Address - Fax:813-567-7006
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN173021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice