Provider Demographics
NPI:1538617303
Name:MCMAHON, MOLLY DILLON (DDS MS)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:DILLON
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:ELIZABETH
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS MS
Mailing Address - Street 1:5009 WILLISTON RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4642
Mailing Address - Country:US
Mailing Address - Phone:612-889-7211
Mailing Address - Fax:
Practice Address - Street 1:1475 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-4571
Practice Address - Country:US
Practice Address - Phone:952-361-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13664122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist