Provider Demographics
NPI:1063527638
Name:MCHALE, JOHN STEVEN JR (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEVEN
Last Name:MCHALE
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 928
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-0928
Mailing Address - Country:US
Mailing Address - Phone:760-749-1123
Mailing Address - Fax:760-749-6593
Practice Address - Street 1:28743 VALLEY CENTER RD STE A
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-6530
Practice Address - Country:US
Practice Address - Phone:760-749-1123
Practice Address - Fax:760-749-6593
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA321311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice