Provider Demographics
NPI:1609990969
Name:CHRISTOPHER E MCLEAN, DDS, LLC
Entity Type:Organization
Organization Name:CHRISTOPHER E MCLEAN, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-972-2915
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:MN
Mailing Address - Zip Code:55328-0410
Mailing Address - Country:US
Mailing Address - Phone:763-972-2915
Mailing Address - Fax:763-972-3975
Practice Address - Street 1:327 13TH ST S
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:MN
Practice Address - Zip Code:55328
Practice Address - Country:US
Practice Address - Phone:763-972-2915
Practice Address - Fax:763-972-3975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental