Provider Demographics
NPI:1952889925
Name:MCKINNEY PERIODONTICS
Entity type:Organization
Organization Name:MCKINNEY PERIODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-569-8448
Mailing Address - Street 1:7785 ELDORADO PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5615
Mailing Address - Country:US
Mailing Address - Phone:972-569-8448
Mailing Address - Fax:214-206-8978
Practice Address - Street 1:7785 ELDORADO PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5615
Practice Address - Country:US
Practice Address - Phone:972-569-8448
Practice Address - Fax:214-206-8978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty