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General NPI Number Information
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NPI Number | 1285037150
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Entity Type | Individual
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Provider Name | MICHAEL ALLAN MEHLHOFF D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 106 19TH AVE SUITE 90
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City | MOLINE
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State | IL
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Zip | 61265-3700
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Country | US
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Telephone | 309-277-6567
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Fax |
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Provider Business Mailing Address
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Address Line | 106 19TH AVE SUITE 90
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City | MOLINE
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State | IL
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Zip | 61265-3700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019030059
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS-09120
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License Number State | IA
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