Provider Demographics
NPI:1457339814
Name:AUSTRINS, MIKELIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIKELIS
Middle Name:
Last Name:AUSTRINS
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 1:1870 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-8509
Mailing Address - Country:US
Mailing Address - Phone:269-544-0205
Mailing Address - Fax:269-345-2032
Practice Address - Street 1:437 STONE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4530
Practice Address - Country:US
Practice Address - Phone:269-345-5431
Practice Address - Fax:269-345-2032
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901009721122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist