Provider Demographics
NPI:1619254398
Name:PINDYCK, MICHELE BARNARD (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:BARNARD
Last Name:PINDYCK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W59N457 HILGEN AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2443
Mailing Address - Country:US
Mailing Address - Phone:971-276-1793
Mailing Address - Fax:
Practice Address - Street 1:205 COMMERCE CT
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-4360
Practice Address - Country:US
Practice Address - Phone:262-379-1401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5522611223G0001X
ORD96861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice