Provider Demographics
NPI:1427367713
Name:PINCUS, MICHAEL ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:PINCUS
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 1:5961 N DALLAS PKWY
Mailing Address - Street 2:UNIT 600
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8519
Mailing Address - Country:US
Mailing Address - Phone:972-416-2330
Mailing Address - Fax:469-368-2650
Practice Address - Street 1:5961 N DALLAS PKWY
Practice Address - Street 2:UNIT 600
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7899
Practice Address - Country:US
Practice Address - Phone:972-416-2330
Practice Address - Fax:469-368-2650
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13380122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist