Provider Demographics
NPI:1164679791
Name:PRICE, MCKINLEY L II (DDS)
Entity Type:Individual
Prefix:DR
First Name:MCKINLEY
Middle Name:L
Last Name:PRICE
Suffix:II
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 1:535 DEAN ST
Mailing Address - Street 2:#912
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2180
Mailing Address - Country:US
Mailing Address - Phone:917-275-4758
Mailing Address - Fax:
Practice Address - Street 1:3915 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1565
Practice Address - Country:US
Practice Address - Phone:212-567-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0541441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery