MEDICARE: DR. MICHAEL CARL PRECISE D.M.D.

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	1223G0001X	General Practice Dentistry	LNO3358	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LNO3358	OTHER	AL	STATE DENTAL BOARD NUMBER

General Provider Information

NPI Number	:	1770526493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL CARL PRECISE D.M.D.

Provider Business Mailing Address
First Line	:	247 GRACELAND DR
Second Line	:
City	:	GENEVA
State	:	AL
Zip	:	36340-6359
Country	:	US
Telephone Number	:	334-684-9868
Fax Number	:

Provider Business Practice Location Address
First Line	:	15622 S. US HWY 231
Second Line	:
City	:	MIDLAND CITY
State	:	AL
Zip	:	36350-0695
Country	:	US
Telephone Number	:	334-983-3558
Fax Number	:	334-983-3255

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MICHAEL CARL PRECISE D.M.D.” Practice Location

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