Provider Demographics
NPI:1073671210
Name:J H MCCLAIN DDS PC
Entity type:Organization
Organization Name:J H MCCLAIN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-683-4976
Mailing Address - Street 1:757 BROOKHAVEN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4503
Mailing Address - Country:US
Mailing Address - Phone:901-683-4976
Mailing Address - Fax:901-685-7781
Practice Address - Street 1:757 BROOKHAVEN CIRCLE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4503
Practice Address - Country:US
Practice Address - Phone:901-683-4976
Practice Address - Fax:901-685-7781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty