Basic Information
| Provider Information | |||||||||
| NPI: | 1477897734 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCLAUGHLIN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | BRYAN | ||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | BLDG 128 CHAFFEE ROAD | ||||||||
| Address2: | USA DENTAC | ||||||||
| City: | FT BLISS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157425935 | ||||||||
| FaxNumber: | 9157425174 | ||||||||
| Practice Location | |||||||||
| Address1: | 6901 HELEN OF TROY STE C | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799113049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155818070 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2012 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 8145 | SC | N | Dental Providers | Dentist | 1223P0700X | 8145 | SC | N | Dental Providers | Dentist | Prosthodontics | 1223P0700X | 32713 | TX | Y | Dental Providers | Dentist | Prosthodontics |
No ID Information.