Provider Demographics
NPI:1093848277
Name:AMERSON, MICHAEL HAROLD (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HAROLD
Last Name:AMERSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W 20TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-1100
Mailing Address - Country:US
Mailing Address - Phone:903-572-1901
Mailing Address - Fax:903-575-0318
Practice Address - Street 1:203 W 20TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-1100
Practice Address - Country:US
Practice Address - Phone:903-572-1901
Practice Address - Fax:903-575-0318
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice