Provider Demographics
NPI:1710218490
Name:MCCANN, JAMES MARTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARTIN
Last Name:MCCANN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:6417 VILLAGGIO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932
Mailing Address - Country:US
Mailing Address - Phone:954-732-2037
Mailing Address - Fax:
Practice Address - Street 1:4270 GORGAS CIR BLDG 1070
Practice Address - Street 2:US ARMY DENTAL COMMAND
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-2639
Practice Address - Country:US
Practice Address - Phone:210-221-8441
Practice Address - Fax:210-221-8810
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT7491917-89031223G0001X, 1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral Practice