Provider Demographics
NPI:1437362811
Name:VUOCOLO, MICHAEL MEYER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MEYER
Last Name:VUOCOLO
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:407 ARROWHEAD BLVD
Mailing Address - Street 2:SUITE 123
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-1255
Mailing Address - Country:US
Mailing Address - Phone:770-471-5005
Mailing Address - Fax:770-471-7638
Practice Address - Street 1:407 ARROWHEAD BLVD
Practice Address - Street 2:SUITE 123
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1255
Practice Address - Country:US
Practice Address - Phone:770-471-5005
Practice Address - Fax:770-471-7638
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA83931223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU22930Medicare UPIN