Provider Demographics
NPI:1962854448
Name:MCLEAN, IAN (DDS)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:MCLEAN
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 1:700 E 9TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203
Mailing Address - Country:US
Mailing Address - Phone:352-317-4541
Mailing Address - Fax:
Practice Address - Street 1:700 E 9TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3360
Practice Address - Country:US
Practice Address - Phone:352-317-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00202870122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist