Provider Demographics
NPI:1679658215
Name:BAHLINGER, MICHAEL EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:BAHLINGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18821 DELAWARE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1926
Mailing Address - Country:US
Mailing Address - Phone:714-596-6690
Mailing Address - Fax:714-596-6590
Practice Address - Street 1:18821 DELAWARE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1926
Practice Address - Country:US
Practice Address - Phone:714-596-6690
Practice Address - Fax:714-596-6590
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA367211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice