Provider Demographics
NPI:1710016670
Name:KAYSER, MICHAEL BENTLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BENTLEY
Last Name:KAYSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54826 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-5625
Mailing Address - Country:US
Mailing Address - Phone:248-601-6320
Mailing Address - Fax:248-601-4416
Practice Address - Street 1:54826 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-5625
Practice Address - Country:US
Practice Address - Phone:248-601-6320
Practice Address - Fax:248-601-4416
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010151911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice