| Johnny L. Mckinnon, Jr., D.d.s., P.a. | |
|
407 North Main Street Mt. Gilead NC 27306-0022 | |
| (910) 439-9744 | |
| (910) 439-4113 |
| Full Name | Johnny L. Mckinnon, Jr., D.d.s., P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 407 North Main Street, Mt. Gilead, North Carolina |
| Authorized Official Name and Position | Johnny L. Mckinnon (PRESIDENT/DENTIST) |
| Authorized Official Contact | 9104399744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnny L. Mckinnon, Jr., D.d.s., P.a. Po Box 22 407 North Main Street Mount Gilead NC 27306-0022 Ph: (910) 439-9744 | Johnny L. Mckinnon, Jr., D.d.s., P.a. 407 North Main Street Mt. Gilead NC 27306-0022 Ph: (910) 439-9744 |
| NPI Number | 1376712075 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 02/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376712075 | NPI | - | NPPES |
| 8995803 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6063 (North Carolina) | Primary |