Provider Demographics
NPI:1821118555
Name:DRS. MCCLAIN & SCHALLHORN PERIODONTICS AND IMPLANT DENTISTRY
Entity Type:Organization
Organization Name:DRS. MCCLAIN & SCHALLHORN PERIODONTICS AND IMPLANT DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-696-7885
Mailing Address - Street 1:11200 E MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3260
Mailing Address - Country:US
Mailing Address - Phone:303-696-7885
Mailing Address - Fax:303-696-1958
Practice Address - Street 1:11200 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3260
Practice Address - Country:US
Practice Address - Phone:303-696-7885
Practice Address - Fax:303-696-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1059411223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty