Johnny L. Mckinnon, Jr., D.d.s., P.a. | |
407 North Main Street Mt. Gilead NC 27306-0022 | |
(910) 439-9744 | |
(910) 439-4113 |
Full Name | Johnny L. Mckinnon, Jr., D.d.s., P.a. |
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Speciality | Dentist - General Practice |
Location | 407 North Main Street, Mt. Gilead, North Carolina |
Authorized Official Name and Position | Johnny L. Mckinnon (PRESIDENT/DENTIST) |
Authorized Official Contact | 9104399744 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Johnny L. Mckinnon, Jr., D.d.s., P.a. Po Box 22 407 North Main Street Mount Gilead NC 27306-0022 Ph: (910) 439-9744 | Johnny L. Mckinnon, Jr., D.d.s., P.a. 407 North Main Street Mt. Gilead NC 27306-0022 Ph: (910) 439-9744 |
NPI Number | 1376712075 |
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Provider Enumeration Date | 02/27/2008 |
Last Update Date | 02/27/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376712075 | NPI | - | NPPES |
8995803 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 6063 (North Carolina) | Primary |