MEDICARE: DR. MICHELLE A GETZ DMD

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	DN 17232	FL

General Provider Information

NPI Number	:	1689641250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE A GETZ DMD

Provider Business Mailing Address
First Line	:	5308 LANCE ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-6920
Country	:	US
Telephone Number	:	850-784-9626
Fax Number	:

Provider Business Practice Location Address
First Line	:	406 N COVE BLVD
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-3726
Country	:	US
Telephone Number	:	850-769-1710
Fax Number	:

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	07/08/2007

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