Most Relevant Information
Provider Data
| NPI Number: | 1003336215 |
| Provider Name: | JAMES NATHAN MCKENNA DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/20/2017 |
| Last Updated: | 04/09/2018 |
Provider Practice Location
230 S 12TH AVE
PHOENIX
AZ
850073101
Practice Location Phone/Fax
| Phone: | 6023620744 |
| Fax: |
Provider Mailing Location
1145 10TH AVE E UNIT 318
SEATTLE
WA
981024086
Provider Mailing Phone/Fax
| Phone: | 5097108180 |
| Fax: |