Provider Demographics
NPI:1790049286
Name:GURNEY, MICHAEL LYNN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LYNN
Last Name:GURNEY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:1803 S TOPAZ WAY, STE 120
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-954-7993
Mailing Address - Fax:208-376-0661
Practice Address - Street 1:1803 S. TOPAZ WAY, STE 120
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642
Practice Address - Country:US
Practice Address - Phone:208-376-0567
Practice Address - Fax:208-376-0661
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDD-43901223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics