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THOMAS G MCKENNA DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1760430714

Individual Registrant:
 THOMAS G MCKENNA DDS
Gender: M

Location and contact information for practice:
202 WEST MAIN STREET  DELCAMBRE, LA 70528 US
Tel: 337-685-4643  Fax: 337-685-4643

Contact information for business:
PO BOX 397  DELCAMBRE, LA 70528 US
Tel: 337-685-4643  Fax: --

Registration Information:
NPI: 1760430714
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
LA2028

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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