Provider Demographics
NPI:1588755748
Name:RONNIE A. MCCAGHREN FAMILY DENTISTRY DMD., PC
Entity type:Organization
Organization Name:RONNIE A. MCCAGHREN FAMILY DENTISTRY DMD., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MCCAGHREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-353-0832
Mailing Address - Street 1:1906 FLINT RD SE.
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6025
Mailing Address - Country:US
Mailing Address - Phone:256-353-0832
Mailing Address - Fax:256-353-0876
Practice Address - Street 1:1906 FLINT RD SE.
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6025
Practice Address - Country:US
Practice Address - Phone:256-353-0832
Practice Address - Fax:256-353-0876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL44491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty