Provider Demographics
NPI:1508556895
Name:FUHST, MICHAEL CHRISTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHRISTIAN
Last Name:FUHST
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 1:1084 S HACKER RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-8914
Mailing Address - Country:US
Mailing Address - Phone:810-599-5176
Mailing Address - Fax:
Practice Address - Street 1:416 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2325
Practice Address - Country:US
Practice Address - Phone:517-546-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI2901601804122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program