Provider Demographics
NPI:1356493902
Name:MCEWEN DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:MCEWEN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANGLER
Authorized Official - Suffix:
Authorized Official - Credentials:RDA
Authorized Official - Phone:931-582-6997
Mailing Address - Street 1:161 RAILROAD ST SOUTH
Mailing Address - Street 2:
Mailing Address - City:MCEWEN
Mailing Address - State:TN
Mailing Address - Zip Code:37101
Mailing Address - Country:US
Mailing Address - Phone:931-582-6997
Mailing Address - Fax:931-582-6989
Practice Address - Street 1:161 RAILROAD ST SOUTH
Practice Address - Street 2:
Practice Address - City:MCEWEN
Practice Address - State:TN
Practice Address - Zip Code:37101
Practice Address - Country:US
Practice Address - Phone:931-582-6997
Practice Address - Fax:931-582-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7681122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1316949282Medicare UPIN
TN5440496Medicare ID - Type Unspecified