Provider Demographics
NPI:1326359787
Name:MILLKEY, MARY CATHERINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CATHERINE
Last Name:MILLKEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 BROOKLINE AVE
Mailing Address - Street 2:APARTMENT 1051
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3938
Mailing Address - Country:US
Mailing Address - Phone:404-271-7836
Mailing Address - Fax:
Practice Address - Street 1:180 BROOKLINE AVE
Practice Address - Street 2:APARTMENT 1051
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3938
Practice Address - Country:US
Practice Address - Phone:404-271-7836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNOT ISSUED YET1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice