Provider Demographics
NPI:1205098217
Name:DENNIS J. MCCOY, D.D.S., P.C.
Entity type:Organization
Organization Name:DENNIS J. MCCOY, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MC COY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-629-1952
Mailing Address - Street 1:1085 CARL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MO
Mailing Address - Zip Code:63077-1601
Mailing Address - Country:US
Mailing Address - Phone:636-629-1952
Mailing Address - Fax:
Practice Address - Street 1:1085 CARL ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MO
Practice Address - Zip Code:63077-1601
Practice Address - Country:US
Practice Address - Phone:636-629-1952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO012720122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty