Provider Demographics
NPI:1922112242
Name:MOTTINGER, MICHELLE H (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:H
Last Name:MOTTINGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 HENRY ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405
Mailing Address - Country:US
Mailing Address - Phone:336-375-1825
Mailing Address - Fax:336-375-7646
Practice Address - Street 1:2710 HENRY ST
Practice Address - Street 2:SUITE 104
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-375-1825
Practice Address - Fax:336-375-7646
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC63681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice