Provider Demographics
NPI:1871644179
Name:KONTER, MICHAEL IRVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:IRVIN
Last Name:KONTER
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 1:11 MEDICAL ARTS CTR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4414
Mailing Address - Country:US
Mailing Address - Phone:912-355-8821
Mailing Address - Fax:912-355-8892
Practice Address - Street 1:11 MEDICAL ARTS CTR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4414
Practice Address - Country:US
Practice Address - Phone:912-355-8821
Practice Address - Fax:912-355-8892
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA77541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice