Provider Demographics
NPI:1457003071
Name:MCMAHON, DDS, INC
Entity Type:Organization
Organization Name:MCMAHON, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE LEAD
Authorized Official - Prefix:
Authorized Official - First Name:CASSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-288-1800
Mailing Address - Street 1:6589 S KINGS RANCH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-2934
Mailing Address - Country:US
Mailing Address - Phone:480-288-1800
Mailing Address - Fax:480-288-1888
Practice Address - Street 1:6589 S KINGS RANCH RD STE 101
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-2934
Practice Address - Country:US
Practice Address - Phone:480-288-1800
Practice Address - Fax:480-288-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental