Provider Demographics
NPI:1861757247
Name:MCLAIN, JAMES EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:MCLAIN
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 1:2121 DELGANY ST
Mailing Address - Street 2:UNIT 1342
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1684
Mailing Address - Country:US
Mailing Address - Phone:810-397-4917
Mailing Address - Fax:
Practice Address - Street 1:2466 S COLORADO BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5931
Practice Address - Country:US
Practice Address - Phone:303-691-6983
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
CODEN002017921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice