Provider Demographics
NPI:1811018237
Name:MCCORMLEY, DON PAUL (DDS)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:PAUL
Last Name:MCCORMLEY
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:PO BOX 185
Mailing Address - Street 2:1014 FIFTH AVE
Mailing Address - City:EAST MC KEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15035-1085
Mailing Address - Country:US
Mailing Address - Phone:412-823-4600
Mailing Address - Fax:
Practice Address - Street 1:1014 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:EAST MC KEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15035-1085
Practice Address - Country:US
Practice Address - Phone:412-823-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist