Provider Demographics
NPI:1144438904
Name:MCNAMARA, JOSEPH A (DDS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:MCNAMARA
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 1:20977 ROUTE 68
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-3619
Mailing Address - Country:US
Mailing Address - Phone:814-745-2288
Mailing Address - Fax:
Practice Address - Street 1:20977 ROUTE 68
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-3619
Practice Address - Country:US
Practice Address - Phone:814-745-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030692L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice