Provider Demographics
NPI:1760832380
Name:MCMAHAN, CORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:
Last Name:MCMAHAN
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 1:491 WILLIAMSON RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9255
Mailing Address - Country:US
Mailing Address - Phone:704-664-3124
Mailing Address - Fax:704-664-3125
Practice Address - Street 1:491 WILLIAMSON RD STE 205
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9255
Practice Address - Country:US
Practice Address - Phone:704-664-3124
Practice Address - Fax:704-664-3125
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice