Provider Demographics
NPI:1700167145
Name:J. BRITT MCCARTY DMD PA
Entity Type:Organization
Organization Name:J. BRITT MCCARTY DMD PA
Other - Org Name:MERIDIAN PEDIATRIC DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BRITT
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-482-8986
Mailing Address - Street 1:1922 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-3107
Mailing Address - Country:US
Mailing Address - Phone:601-482-8986
Mailing Address - Fax:601-482-6100
Practice Address - Street 1:1922 23RD AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-3107
Practice Address - Country:US
Practice Address - Phone:601-482-8986
Practice Address - Fax:601-482-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPEDO129-87261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental