Provider Demographics
NPI:1891959151
Name:MICHAEL A. DASINGER
Entity Type:Organization
Organization Name:MICHAEL A. DASINGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BARROW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-867-6837
Mailing Address - Street 1:422 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-2052
Mailing Address - Country:US
Mailing Address - Phone:251-867-6837
Mailing Address - Fax:251-867-6278
Practice Address - Street 1:422 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-2052
Practice Address - Country:US
Practice Address - Phone:251-867-6837
Practice Address - Fax:251-867-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1538269576Medicaid