Provider Demographics
NPI:1053328674
Name:DOZIER, MICHELE LEANN (DDS)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEANN
Last Name:DOZIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 SLIGO CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5806
Mailing Address - Country:US
Mailing Address - Phone:301-891-7760
Mailing Address - Fax:301-891-7791
Practice Address - Street 1:1107 SLIGO CREEK PKWY
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5806
Practice Address - Country:US
Practice Address - Phone:301-891-7760
Practice Address - Fax:301-891-7791
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0017534OtherDORAL DENTAL