Provider Demographics
NPI:1902161334
Name:MCVEAN, JOHN D (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:MCVEAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 TIMBER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4280
Mailing Address - Country:US
Mailing Address - Phone:901-756-1864
Mailing Address - Fax:
Practice Address - Street 1:124 TIMBER CREEK DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4280
Practice Address - Country:US
Practice Address - Phone:901-756-1864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000002516122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist