Provider Demographics
NPI:1700866530
Name:LEARMAN, MICHAEL E (DDS, PLC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:LEARMAN
Suffix:
Gender:M
Credentials:DDS, PLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 SHRESTHA DR
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2171
Mailing Address - Country:US
Mailing Address - Phone:989-667-5630
Mailing Address - Fax:989-667-5726
Practice Address - Street 1:4141 SHRESTHA DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2171
Practice Address - Country:US
Practice Address - Phone:989-667-5630
Practice Address - Fax:989-667-5726
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI14212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI202055563OtherTAX NUMBER