Provider Demographics
NPI:1821086885
Name:MCCLENAHAN, DANIEL D (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:MCCLENAHAN
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 264
Mailing Address - Street 2:
Mailing Address - City:OVERTON
Mailing Address - State:NE
Mailing Address - Zip Code:68863-0264
Mailing Address - Country:US
Mailing Address - Phone:308-987-2437
Mailing Address - Fax:308-987-2342
Practice Address - Street 1:401 5TH STREET
Practice Address - Street 2:
Practice Address - City:OVERTON
Practice Address - State:NE
Practice Address - Zip Code:68863-0264
Practice Address - Country:US
Practice Address - Phone:308-987-2437
Practice Address - Fax:308-987-2342
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE47581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice