Provider Demographics
NPI:1114058336
Name:MICHAEL W FUREY DDS, PA
Entity Type:Organization
Organization Name:MICHAEL W FUREY DDS, PA
Other - Org Name:THE FUREY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:FUREY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:651-490-9011
Mailing Address - Street 1:700 VILLAGE CENTER DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-3019
Mailing Address - Country:US
Mailing Address - Phone:651-490-9011
Mailing Address - Fax:651-490-5081
Practice Address - Street 1:700 VILLAGE CENTER DR
Practice Address - Street 2:SUITE 120
Practice Address - City:NORTH OAKS
Practice Address - State:MN
Practice Address - Zip Code:55127-3019
Practice Address - Country:US
Practice Address - Phone:651-490-9011
Practice Address - Fax:651-490-5081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9131261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental