Provider Demographics
NPI:1528218732
Name:TILMANN, MICHAEL DONALD (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DONALD
Last Name:TILMANN
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 1:3741 WHITEHOUSE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:31830
Mailing Address - Country:US
Mailing Address - Phone:706-655-2700
Mailing Address - Fax:706-655-2700
Practice Address - Street 1:3741 WHITEHOUSE PARKWAY
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830
Practice Address - Country:US
Practice Address - Phone:706-655-2700
Practice Address - Fax:706-655-2700
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist