Mckissock Corp.
NPI #1477938140 in Windermere, Florida
Provider Information
- NPI Number
- 1477938140
- Entity Type
- Organization
- Organization Name
- Mckissock Corp.
- Primary Specialty
- Dentist
- Enumeration Date
- Jul 23, 2015
- Last Updated
- Aug 11, 2015
Practice Location
- Address
- 4769 THE GROVE DR
- Address 2
- SUITE 100
- City
- Windermere
- State
- Florida
- ZIP Code
- 34786-8421
- Phone
- (407) 909-1099
Authorized Official
- Name
- DR. MATTHEW DEAN MCKISSOCK, D.M.D.
- Title
- OWNER/PRESIDENT
- Phone
- (407) 909-1099
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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