MEDICARE: DR. MICHAEL DAVID LING DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D11532	MN

General Provider Information

NPI Number	:	1659343127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DAVID LING DDS

Provider Business Mailing Address
First Line	:	7766 HIGHWAY 65 NE
Second Line	:
City	:	SPRING LAKE PARK
State	:	MN
Zip	:	55432-2832
Country	:	US
Telephone Number	:	763-784-1993
Fax Number	:	763-784-1575

Provider Business Practice Location Address
First Line	:	7766 HIGHWAY 65 NE
Second Line	:
City	:	SPRING LAKE PARK
State	:	MN
Zip	:	55432-2832
Country	:	US
Telephone Number	:	763-784-1993
Fax Number	:	763-784-1575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/08/2007

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