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General NPI Number Information
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NPI Number | 1285608141
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Entity Type | Individual
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Provider Name | DALE JOSEPH MISIEK DMD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 1225 WATERSTONE BLVD
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City | FRANKLIN
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State | TN
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Zip | 37069-7210
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Country | US
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Telephone | 985-789-5808
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 WATERSTONE BLVD
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City | FRANKLIN
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State | TN
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Zip | 37069-7210
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Country | US
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Telephone | 985-789-5808
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 6847
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3361
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 12133
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License Number State | TN
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