Mckinney, Dan Richard

Mckinney, Dan Richard is an sole proprietor health care provider with primary practice located at 116 W 21St St , Clovis NM 88101-4364. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mckinney, Dan Richard can be contacted via phone (505) 763-4851.

Contact Information

Primary practice address
116 W 21St St Clovis NM 88101-4364
Fax: (505) 769-0249
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DD822 New Mexico

Profile Details

NPI number 1073594214
LBN Legal business name Mckinney, Dan Richard
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2005
Last updated Dec 21st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073594214 NPPES
New Mexico MEDICAID 008419
New Mexico Other 85522

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