Provider Demographics
NPI:1821642315
Name:MICHAEL J. DIONISE, DDS., PC
Entity Type:Organization
Organization Name:MICHAEL J. DIONISE, DDS., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIONISE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-484-8910
Mailing Address - Street 1:610 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48933-2407
Mailing Address - Country:US
Mailing Address - Phone:517-484-8910
Mailing Address - Fax:
Practice Address - Street 1:610 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-2407
Practice Address - Country:US
Practice Address - Phone:517-484-8910
Practice Address - Fax:517-482-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty