Provider Demographics
NPI:1447501424
Name:MCCRARY, THOMAS ANDREW JR (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDREW
Last Name:MCCRARY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 OLD GALLOWS RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3971
Mailing Address - Country:US
Mailing Address - Phone:703-827-0770
Mailing Address - Fax:703-821-5058
Practice Address - Street 1:1954 OLD GALLOWS RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3971
Practice Address - Country:US
Practice Address - Phone:703-827-0770
Practice Address - Fax:703-821-5058
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010004121122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist