Provider Demographics
NPI:1346926227
Name:MACKNIGHT, MICHAEL A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:MACKNIGHT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21018 OHIO RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:WV
Mailing Address - Zip Code:25260
Mailing Address - Country:US
Mailing Address - Phone:304-773-5620
Mailing Address - Fax:
Practice Address - Street 1:21018 OHIO RIVER RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:WV
Practice Address - Zip Code:25260
Practice Address - Country:US
Practice Address - Phone:304-773-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV46401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice