Provider Demographics
NPI:1861511578
Name:MCANLY, JAMES R (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:MCANLY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 STREAMVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6409
Mailing Address - Country:US
Mailing Address - Phone:407-310-3181
Mailing Address - Fax:
Practice Address - Street 1:2216 E SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5733
Practice Address - Country:US
Practice Address - Phone:407-889-4360
Practice Address - Fax:407-889-2035
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL152061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice