Provider Demographics
NPI:1487669164
Name:HALCOMB, MICHELLE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:M
Last Name:HALCOMB
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:POSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:703 DEL WEBB BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573
Mailing Address - Country:US
Mailing Address - Phone:813-634-3396
Mailing Address - Fax:813-634-3397
Practice Address - Street 1:703 DEL WEBB BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573
Practice Address - Country:US
Practice Address - Phone:813-634-3396
Practice Address - Fax:813-634-3397
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN138091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice