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NPI Code Detail

MEDICARE: MICHAEL TODD VALENTINE D.D.S.

MEDICARE: MICHAEL TODD VALENTINE D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2901017458MI

General Provider Information

NPI Number : 1639296585
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL TODD VALENTINE D.D.S.
Provider Business Mailing Address
First Line : 759 N MONROE ST
Second Line :
City : MONROE
State : MI
Zip : 48162-2936
Country : US
Telephone Number : 734-241-1144
Fax Number : 734-241-6455
Provider Business Practice Location Address
First Line : 759 N MONROE ST
Second Line :
City : MONROE
State : MI
Zip : 48162-2936
Country : US
Telephone Number : 734-241-1144
Fax Number : 734-241-6455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2007
Last Update Date : 07/08/2007

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