Provider Demographics
NPI:1801351242
Name:DAN P MCCAULEY DDS PA
Entity type:Organization
Organization Name:DAN P MCCAULEY DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-572-3981
Mailing Address - Street 1:1603 NORTH JEFFERSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455
Mailing Address - Country:US
Mailing Address - Phone:903-572-3981
Mailing Address - Fax:903-577-0643
Practice Address - Street 1:1603 NORTH JEFFERSON AVENUE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455
Practice Address - Country:US
Practice Address - Phone:903-572-3981
Practice Address - Fax:903-577-0643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty