Provider Demographics
NPI:1881684801
Name:MCGRATH, MARK WHITNEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WHITNEY
Last Name:MCGRATH
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 1:8401 BROWNSBORO RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-1626
Mailing Address - Country:US
Mailing Address - Phone:502-425-2964
Mailing Address - Fax:502-425-2954
Practice Address - Street 1:8401 BROWNSBORO RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1626
Practice Address - Country:US
Practice Address - Phone:502-425-2964
Practice Address - Fax:502-425-2954
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY61751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice