Provider Demographics
NPI:1902921893
Name:MCFEE, TRAVIS L (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:L
Last Name:MCFEE
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 1:1251 LANCASTER DR NE STE B
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1994
Mailing Address - Country:US
Mailing Address - Phone:503-587-9633
Mailing Address - Fax:503-393-8660
Practice Address - Street 1:1251 LANCASTER DR NE STE B
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1994
Practice Address - Country:US
Practice Address - Phone:503-587-9633
Practice Address - Fax:503-393-8660
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD59141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice