Provider Demographics
NPI:1396759437
Name:MCCARTIN, JOSEPH GERARD SR (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GERARD
Last Name:MCCARTIN
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 S KEDZIE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2000
Mailing Address - Country:US
Mailing Address - Phone:773-238-2906
Mailing Address - Fax:773-238-7885
Practice Address - Street 1:10401 S KEDZIE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2000
Practice Address - Country:US
Practice Address - Phone:773-238-2906
Practice Address - Fax:773-238-7885
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice