Provider Demographics
NPI:1225119274
Name:HONEY CREEK DENTAL ASSOCIATION
Entity Type:Organization
Organization Name:HONEY CREEK DENTAL ASSOCIATION
Other - Org Name:MCDONOUGH FAMILY DENTAL ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCMULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-957-5214
Mailing Address - Street 1:400 MCDONOUGH PKWY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8946
Mailing Address - Country:US
Mailing Address - Phone:770-957-5214
Mailing Address - Fax:770-957-5215
Practice Address - Street 1:400 MCDONOUGH PKWY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8946
Practice Address - Country:US
Practice Address - Phone:770-957-5214
Practice Address - Fax:770-957-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty