Provider Demographics
NPI:1316028459
Name:MCLAWS, NATHAN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:L
Last Name:MCLAWS
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 1:215 S POWER RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-5236
Mailing Address - Country:US
Mailing Address - Phone:480-985-8929
Mailing Address - Fax:480-218-1605
Practice Address - Street 1:215 SOUTH POWER ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:480-985-8929
Practice Address - Fax:480-218-1605
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice