Provider Demographics
NPI:1295805414
Name:DEUTCH, MICHELLE BETH (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BETH
Last Name:DEUTCH
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 1:8575 W 110TH ST
Mailing Address - Street 2:SUITE 326
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1865
Mailing Address - Country:US
Mailing Address - Phone:913-469-0085
Mailing Address - Fax:913-345-1540
Practice Address - Street 1:8575 W 110TH ST
Practice Address - Street 2:SUITE 326
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1865
Practice Address - Country:US
Practice Address - Phone:913-469-0085
Practice Address - Fax:913-345-1540
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS64681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice