Provider Demographics
NPI:1295089654
Name:MCKEE, WILLIAM J (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:MCKEE
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 1:113 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:LACYGNE
Mailing Address - State:KS
Mailing Address - Zip Code:66040-4205
Mailing Address - Country:US
Mailing Address - Phone:913-757-4429
Mailing Address - Fax:
Practice Address - Street 1:113 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LACYGNE
Practice Address - State:KS
Practice Address - Zip Code:66040-4205
Practice Address - Country:US
Practice Address - Phone:913-757-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist