Provider Demographics
NPI:1184772212
Name:MCCREARY, DAVID RICHARD (DMD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RICHARD
Last Name:MCCREARY
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 1:222 OAKRIDGE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-4080
Mailing Address - Country:US
Mailing Address - Phone:386-253-1272
Mailing Address - Fax:386-423-3653
Practice Address - Street 1:222 OAKRIDGE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-4080
Practice Address - Country:US
Practice Address - Phone:386-253-1272
Practice Address - Fax:386-423-3653
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN152071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice