Provider Demographics
NPI:1275695140
Name:MCNAMARA, JAMES M (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:MCNAMARA
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 1:13997 W HWY 53
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858
Mailing Address - Country:US
Mailing Address - Phone:208-687-0688
Mailing Address - Fax:208-687-0447
Practice Address - Street 1:13997 W HWY 53
Practice Address - Street 2:
Practice Address - City:RATHDRUM
Practice Address - State:ID
Practice Address - Zip Code:83858
Practice Address - Country:US
Practice Address - Phone:208-687-0688
Practice Address - Fax:208-687-0447
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD1605122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist