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General NPI Number Information
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NPI Number | 1881199974
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Entity Type | Individual
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Provider Name | MICHAEL ERNEST LOVE DMD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 1205 BOLL WEEVIL CIR
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City | ENTERPRISE
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State | AL
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Zip | 36330-1377
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Country | US
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Telephone | 334-806-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 800 GEORGE WALLACE DR
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City | ENTERPRISE
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State | AL
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Zip | 36330-3201
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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 | D.007260-C
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License Number State | AL
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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 | 2018018496
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN28683
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License Number State | FL
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