Provider Demographics
NPI:1659448439
Name:DR. MICHAEL J. GEARING D.D.S. INC
Entity Type:Organization
Organization Name:DR. MICHAEL J. GEARING D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GEARING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:618-252-6714
Mailing Address - Street 1:125 W CLARK ST
Mailing Address - Street 2:STE 2
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-2738
Mailing Address - Country:US
Mailing Address - Phone:618-252-6714
Mailing Address - Fax:618-252-6072
Practice Address - Street 1:125 W CLARK ST
Practice Address - Street 2:STE 2
Practice Address - City:HARRISBURG
Practice Address - State:IL
Practice Address - Zip Code:62946-2738
Practice Address - Country:US
Practice Address - Phone:618-252-6714
Practice Address - Fax:618-252-6072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty