Provider Demographics
NPI:1649369711
Name:EKLUND, MICHAEL KEITH (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KEITH
Last Name:EKLUND
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:24 E GREENWAY PLZ
Mailing Address - Street 2:SUITE 1708
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-2401
Mailing Address - Country:US
Mailing Address - Phone:713-439-7575
Mailing Address - Fax:713-439-0924
Practice Address - Street 1:24 E GREENWAY PLZ
Practice Address - Street 2:SUITE 1708
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046-2401
Practice Address - Country:US
Practice Address - Phone:713-439-7575
Practice Address - Fax:713-439-0924
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX94911223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery