Provider Demographics
NPI:1265660435
Name:MCKEE, STEPHEN LYNNE (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LYNNE
Last Name:MCKEE
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:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:NY
Mailing Address - Zip Code:14892-0190
Mailing Address - Country:US
Mailing Address - Phone:607-565-7811
Mailing Address - Fax:607-565-7165
Practice Address - Street 1:403 CHEMUNG ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:NY
Practice Address - Zip Code:14892-1428
Practice Address - Country:US
Practice Address - Phone:607-565-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2845122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist