Provider Demographics
NPI:1720003585
Name:PASHLEY, MICHAEL R (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:PASHLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13112 NEWPORT AVE
Mailing Address - Street 2:STE. K
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3425
Mailing Address - Country:US
Mailing Address - Phone:714-544-8030
Mailing Address - Fax:714-838-2609
Practice Address - Street 1:13112 NEWPORT AVE
Practice Address - Street 2:STE. K
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3425
Practice Address - Country:US
Practice Address - Phone:714-544-8030
Practice Address - Fax:714-838-2609
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA193771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics