Provider Demographics
NPI:1801036652
Name:MCKAY'S MILL DENTAL
Entity Type:Organization
Organization Name:MCKAY'S MILL DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-498-4323
Mailing Address - Street 1:2090 OXFORD GLN
Mailing Address - Street 2:SUITE 500
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8656
Mailing Address - Country:US
Mailing Address - Phone:615-595-5959
Mailing Address - Fax:615-595-5966
Practice Address - Street 1:2090 OXFORD GLN
Practice Address - Street 2:SUITE 500
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8656
Practice Address - Country:US
Practice Address - Phone:615-595-5959
Practice Address - Fax:615-595-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7855261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center