Provider Demographics
NPI:1508075151
Name:DRS. GEORGE AND CATHY MICHAEL
Entity Type:Organization
Organization Name:DRS. GEORGE AND CATHY MICHAEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:845-758-5161
Mailing Address - Street 1:90 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1540
Mailing Address - Country:US
Mailing Address - Phone:845-758-5161
Mailing Address - Fax:845-758-8035
Practice Address - Street 1:90 W MARKET ST
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-1540
Practice Address - Country:US
Practice Address - Phone:845-758-5161
Practice Address - Fax:845-758-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032161122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty