Provider Demographics
NPI:1215194162
Name:MICHAEL F. ALSPAUGH
Entity Type:Organization
Organization Name:MICHAEL F. ALSPAUGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALSPAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-340-3880
Mailing Address - Street 1:609 S KELLY AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5659
Mailing Address - Country:US
Mailing Address - Phone:405-340-3880
Mailing Address - Fax:403-341-3630
Practice Address - Street 1:609 S KELLY AVE
Practice Address - Street 2:SUITE A1
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5659
Practice Address - Country:US
Practice Address - Phone:405-340-3880
Practice Address - Fax:405-341-3630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty