Provider Demographics
NPI:1326172677
Name:MCENERY, MARY CATHERINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CATHERINE
Last Name:MCENERY
Suffix:
Gender:F
Credentials:DMD
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 70
Mailing Address - Street 2:100 CHEYENNE AVE.
Mailing Address - City:LAME DEER
Mailing Address - State:MT
Mailing Address - Zip Code:59043-0070
Mailing Address - Country:US
Mailing Address - Phone:406-477-4464
Mailing Address - Fax:
Practice Address - Street 1:100 CHEYENNE AVE.
Practice Address - Street 2:70
Practice Address - City:LAME DEER
Practice Address - State:MT
Practice Address - Zip Code:59043-0070
Practice Address - Country:US
Practice Address - Phone:406-477-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD70711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry