Provider Demographics
NPI:1467627356
Name:J ANDREW MCKAMIE DDS PC
Entity Type:Organization
Organization Name:J ANDREW MCKAMIE DDS PC
Other - Org Name:CENTER FOR EXCEPTIONAL DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MCKAMIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-789-7893
Mailing Address - Street 1:3645 N COUNCIL RD
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-3507
Mailing Address - Country:US
Mailing Address - Phone:405-789-7893
Mailing Address - Fax:405-789-8377
Practice Address - Street 1:3645 N COUNCIL RD
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-3507
Practice Address - Country:US
Practice Address - Phone:405-789-7893
Practice Address - Fax:405-789-8377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK43711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty