Provider Demographics
NPI:1992054076
Name:MCDONALD, MARCEY Y (DMD)
Entity type:Individual
Prefix:
First Name:MARCEY
Middle Name:Y
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 E VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4735
Mailing Address - Country:US
Mailing Address - Phone:602-618-9253
Mailing Address - Fax:
Practice Address - Street 1:20235 N CAVE CREEK RD
Practice Address - Street 2:SUITE 106
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-4424
Practice Address - Country:US
Practice Address - Phone:602-971-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD008460122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist