Provider Demographics
NPI:1326650961
Name:MCGANN FAMILY DENTAL
Entity Type:Organization
Organization Name:MCGANN FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-771-1337
Mailing Address - Street 1:8981 33RD ST N
Mailing Address - Street 2:
Mailing Address - City:LAKE ELMO
Mailing Address - State:MN
Mailing Address - Zip Code:55042-9209
Mailing Address - Country:US
Mailing Address - Phone:651-777-1337
Mailing Address - Fax:
Practice Address - Street 1:8981 33RD ST N
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042-9209
Practice Address - Country:US
Practice Address - Phone:651-777-1337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty