Provider Demographics
NPI:1871676072
Name:APPLETON, MICHAEL J (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:APPLETON
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 1:480 OAK HARBOR BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-8817
Mailing Address - Country:US
Mailing Address - Phone:985-649-9455
Mailing Address - Fax:985-649-9467
Practice Address - Street 1:480 OAK HARBOR BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-8817
Practice Address - Country:US
Practice Address - Phone:985-649-9455
Practice Address - Fax:985-649-9467
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA50851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF6284OtherBLUE CROSS BLUE SHIELD