Provider Demographics
NPI:1184460784
Name:MICHAEL J NEISH DMD PLLC
Entity type:Organization
Organization Name:MICHAEL J NEISH DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEISH
Authorized Official - Suffix:
Authorized Official - Credentials:GENERAL DENTIST
Authorized Official - Phone:253-853-7354
Mailing Address - Street 1:5201 OLYMPIC DR STE 270
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1778
Mailing Address - Country:US
Mailing Address - Phone:253-853-7354
Mailing Address - Fax:
Practice Address - Street 1:5201 OLYMPIC DR STE 270
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1778
Practice Address - Country:US
Practice Address - Phone:253-853-7354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty