Provider Demographics
NPI:1801007455
Name:JOHN P MCREE, D.D.S.,. L.L.C.
Entity Type:Organization
Organization Name:JOHN P MCREE, D.D.S.,. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MCREE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:616-842-2960
Mailing Address - Street 1:3555 PRATT LAKE AVE SE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-9376
Mailing Address - Country:US
Mailing Address - Phone:616-897-4807
Mailing Address - Fax:616-842-2960
Practice Address - Street 1:17088 ROBBINS RD
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2791
Practice Address - Country:US
Practice Address - Phone:616-842-2960
Practice Address - Fax:616-842-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901014870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIJ800322OtherBLUE CROSS BLUE SHIELD
MA512010OtherUNITED CONCORDIA