Bruce A Mickelson in Grand Rapids - Dentist
Bruce A Mickelson - NPI 1760555692
Bruce A Mickelson is a Dentist in Grand Rapids, Michigan. Bruce A Mickelson practices all healthcare services and medical treatments related to Dentist. The NPI Number for Bruce A Mickelson is 1760555692. The last update date is 2007-07-08.
Bruce A Mickelson's current location address is 976 3 Mile Rd Nw, Grand Rapids, Michigan. You can contact this provider via phone number 6167844038 and fax number 6167859501. The mailing address for Bruce A Mickelson is 976 3 Mile Rd Nw, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bruce A Mickelson |
|---|---|
| Address | 976 3 Mile Rd Nw, Grand Rapids, Michigan |
| Phone Number | 6167844038 |
| Fax Number | 6167859501 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1760555692 |
|---|---|
| Provider Enumeration Date | 2006-11-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 976 3 Mile Rd Nw |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 49544 |
| Phone Number | 6167844038 |
| Fax Number | 6167859501 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 11496 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code issued to Bruce A Mickelson by the Centers for Medicare & Medicaid Services?
The Bruce A Mickelson has been assigned the NPI (National Provider Identifier) 1760555692 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Bruce A Mickelson's facilities are situated?
The facilities of Bruce A Mickelson are physically located at the following address: 976 3 Mile Rd Nw, Grand Rapids, MI, 49544.
What is Bruce A Mickelson's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Bruce A Mickelson is Dentist, and the taxonomy code that categorizes this field of expertise is 122300000X.
On what date did Bruce A Mickelson receive its 1760555692 assignment from the Centers for Medicare & Medicaid Services?
The Bruce A Mickelson was assigned its 1760555692 on 2006-11-16, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Bruce A Mickelson most recently updated?
The details pertaining to the Bruce A Mickelson, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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