Provider Demographics
NPI:1619533486
Name:MICHELLE L. PIPER, DDS, PLLC
Entity Type:Organization
Organization Name:MICHELLE L. PIPER, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:GRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-744-8000
Mailing Address - Street 1:1810 RUDDIMAN DR
Mailing Address - Street 2:
Mailing Address - City:N MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-3172
Mailing Address - Country:US
Mailing Address - Phone:231-744-8000
Mailing Address - Fax:231-744-8686
Practice Address - Street 1:1810 RUDDIMAN DR
Practice Address - Street 2:
Practice Address - City:N MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-3172
Practice Address - Country:US
Practice Address - Phone:231-744-8000
Practice Address - Fax:231-744-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty