Provider Demographics
NPI:1003900234
Name:MICHAEL P. MCCORMICK JR., D.D.S., P.C.
Entity Type:Organization
Organization Name:MICHAEL P. MCCORMICK JR., D.D.S., P.C.
Other - Org Name:CARING FOR KIDS AND PARENTS
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:G
Authorized Official - Last Name:BUNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-896-5050
Mailing Address - Street 1:901 ENTERPRISE PKWY STE 500
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6253
Mailing Address - Country:US
Mailing Address - Phone:757-896-4900
Mailing Address - Fax:757-896-4905
Practice Address - Street 1:901 ENTERPRISE PKWY STE 500
Practice Address - Street 2:SUITE 500
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6253
Practice Address - Country:US
Practice Address - Phone:757-896-4900
Practice Address - Fax:757-896-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty