Healthcare Provider Details

I. General information

NPI: 1619533486
Provider Name (Legal Business Name): MICHELLE L. PIPER, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 RUDDIMAN DR
N MUSKEGON MI
49445-3172
US

IV. Provider business mailing address

1810 RUDDIMAN DR
N MUSKEGON MI
49445-3172
US

V. Phone/Fax

Practice location:
  • Phone: 231-744-8000
  • Fax: 231-744-8686
Mailing address:
  • Phone: 231-744-8000
  • Fax: 231-744-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALICIA RAE GRENNAN
Title or Position: DENTAL CONSULTANT
Credential:
Phone: 231-744-8000