Provider Demographics
NPI:1821080128
Name:BACHMAN, MICHAEL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:BACHMAN
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 1:700 N SANDERS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3528
Mailing Address - Country:US
Mailing Address - Phone:760-375-8512
Mailing Address - Fax:760-375-3275
Practice Address - Street 1:700 N SANDERS ST
Practice Address - Street 2:SUITE B
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3528
Practice Address - Country:US
Practice Address - Phone:760-375-8512
Practice Address - Fax:760-375-3275
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice