| Mckissock Corp. | |
|
4769 The Grove Dr Suite 100 Windermere FL 34786-8421 | |
| (407) 909-1099 | |
| Not Available |
| Full Name | Mckissock Corp. |
|---|---|
| Speciality | Dentist |
| Location | 4769 The Grove Dr, Windermere, Florida |
| Authorized Official Name and Position | Matthew Dean Mckissock (OWNER/PRESIDENT) |
| Authorized Official Contact | 4079091099 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mckissock Corp. 4769 The Grove Dr Suite 100 Windermere FL 34786-8421 Ph: (407) 909-1099 | Mckissock Corp. 4769 The Grove Dr Suite 100 Windermere FL 34786-8421 Ph: (407) 909-1099 |
| NPI Number | 1477938140 |
|---|---|
| Provider Enumeration Date | 07/23/2015 |
| Last Update Date | 08/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477938140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN14895 (Florida) | Primary |
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