Provider Demographics
NPI:1396815635
Name:MACKIN, JOHN FRANCIS (DMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:MACKIN
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 1:303 LOCH LOMOND RD
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-1954
Mailing Address - Country:US
Mailing Address - Phone:814-342-7490
Mailing Address - Fax:
Practice Address - Street 1:303 LOCH LOMOND RD
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-1954
Practice Address - Country:US
Practice Address - Phone:814-342-7490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029027L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice