Provider Demographics
NPI:1821609934
Name:TCHIDA, MICHAEL DUPLESSIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DUPLESSIS
Last Name:TCHIDA
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:PO BOX 929
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-0929
Mailing Address - Country:US
Mailing Address - Phone:715-387-1702
Mailing Address - Fax:
Practice Address - Street 1:306 W MCMILLAN ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-6013
Practice Address - Country:US
Practice Address - Phone:715-387-1702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002407-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist