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General NPI Number Information
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NPI Number | 1841390473
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Entity Type | Individual
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Provider Name | MICHAEL DEAN COLE DDS
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 12001 SOUTH FREEWAY SUITE 207
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City | BURLESON
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State | TX
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Zip | 76028
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Country | US
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Telephone | 817-568-6811
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Fax | 817-568-6813
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Provider Business Mailing Address
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Address Line | 12001 SOUTH FREEWAY SUITE 207
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City | BURLESON
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State | TX
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Zip | 76028
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Country | US
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Telephone | 817-568-6811
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Fax | 817-568-6813
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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 | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 14389
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License Number State | TX
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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 | 14389
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License Number State | TX
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