Provider Demographics
NPI:1487837449
Name:AYRES, MICHELLE KNISLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:KNISLEY
Last Name:AYRES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661-9757
Mailing Address - Country:US
Mailing Address - Phone:740-289-2371
Mailing Address - Fax:740-289-4291
Practice Address - Street 1:130 WAYNE FRYE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45144-9314
Practice Address - Country:US
Practice Address - Phone:937-549-1270
Practice Address - Fax:937-549-1286
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30019746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist