Provider Demographics
NPI:1508029331
Name:MCNAIR, DANIEL S (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:MCNAIR
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 1:125 E 3RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3822
Mailing Address - Country:US
Mailing Address - Phone:405-703-5344
Mailing Address - Fax:405-703-5343
Practice Address - Street 1:125 E 3RD ST STE A
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3822
Practice Address - Country:US
Practice Address - Phone:405-703-5344
Practice Address - Fax:405-703-5343
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200202800AMedicaid