Mccollough, David Mark
Mccollough, David Mark is an individual health care provider with primary practice located at 3750 Chemawa Rd Ne Chemawa Indian Health Center, Salem OR 97305-1111. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Mccollough, David Mark can be contacted via phone (503) 304-7600.Contact Information
Primary practice address
3750 Chemawa Rd Ne Chemawa Indian Health Center
Salem OR 97305-1111
Phone: (503) 304-7600
Fax: (503) 304-7677
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 4022 | Alabama |
Profile Details
| NPI number | 1265476188 |
|---|---|
| LBN Legal business name | Mccollough, David Mark |
| Credentials | DMD MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265476188 | NPPES |
| Oregon | MEDICAID | 278159 |
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