Provider Demographics
NPI:1235293614
Name:MCCLARY, JAMES FREDERICK JR (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FREDERICK
Last Name:MCCLARY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-6554
Mailing Address - Country:US
Mailing Address - Phone:843-873-1646
Mailing Address - Fax:843-873-1617
Practice Address - Street 1:503 N PINE ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6554
Practice Address - Country:US
Practice Address - Phone:843-873-1646
Practice Address - Fax:843-873-1617
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice