Provider Demographics
NPI:1689637324
Name:O'RIORDAN, MICHAEL W (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:O'RIORDAN
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11662 MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-4588
Mailing Address - Country:US
Mailing Address - Phone:586-754-6300
Mailing Address - Fax:586-754-6407
Practice Address - Street 1:11662 MARTIN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-4588
Practice Address - Country:US
Practice Address - Phone:586-754-6300
Practice Address - Fax:586-754-6407
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI104661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry