Provider Demographics
NPI:1679602940
Name:MCGRANE, JOHN PATRICK (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:MCGRANE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 CENTER POINT RD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5571
Mailing Address - Country:US
Mailing Address - Phone:319-294-2281
Mailing Address - Fax:319-294-5783
Practice Address - Street 1:3605 CENTER POINT RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5571
Practice Address - Country:US
Practice Address - Phone:319-294-2281
Practice Address - Fax:319-294-5783
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice