Provider Demographics
NPI:1093898827
Name:MCAULIFFE, JEFFREY ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:MCAULIFFE
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 1:5649 WYNNEWOOD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAURYS STATION
Mailing Address - State:PA
Mailing Address - Zip Code:18059
Mailing Address - Country:US
Mailing Address - Phone:610-261-1131
Mailing Address - Fax:610-261-3601
Practice Address - Street 1:5649 WYNNEWOOD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:LAURYS STATION
Practice Address - State:PA
Practice Address - Zip Code:18059
Practice Address - Country:US
Practice Address - Phone:610-261-1131
Practice Address - Fax:610-261-3601
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA027001L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist