Provider Demographics
NPI:1477550952
Name:TINKLER, MICHAEL R (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:TINKLER
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 1:821 NICKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-1739
Mailing Address - Country:US
Mailing Address - Phone:937-778-1623
Mailing Address - Fax:
Practice Address - Street 1:821 NICKLIN AVE
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-1739
Practice Address - Country:US
Practice Address - Phone:937-778-1623
Practice Address - Fax:937-778-0359
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0127841223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology