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General NPI Number Information
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NPI Number | 1750071312
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Entity Type | Individual
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Provider Name | MICHELLE PINON
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Gender | Female
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 21 PEACE ST
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City | PROVIDENCE
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State | RI
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Zip | 02907-1510
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Country | US
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Telephone | 646-501-4237
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Fax |
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Provider Business Mailing Address
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Address Line | 191 EL DORADO PKWY
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City | PLANTATION
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State | FL
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Zip | 33317-3213
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Country | US
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Telephone | 954-258-8624
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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 | 28531
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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