Provider Demographics
NPI:1518306406
Name:MCRORY, MICHAEL ERIC (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ERIC
Last Name:MCRORY
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 1:3031 ORLEANS ST
Mailing Address - Street 2:BELLINGHAM
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-3557
Mailing Address - Country:US
Mailing Address - Phone:360-676-1138
Mailing Address - Fax:360-752-0507
Practice Address - Street 1:3031 ORLEANS ST
Practice Address - Street 2:BELLINGHAM
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-3557
Practice Address - Country:US
Practice Address - Phone:360-676-1138
Practice Address - Fax:360-752-0507
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 00007473122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist