Provider Demographics
NPI:1649370024
Name:MULVEHILL, MICHAEL JOHN III (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:MULVEHILL
Suffix:III
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 1:624 W DUARTE RD
Mailing Address - Street 2:STE 204
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007
Mailing Address - Country:US
Mailing Address - Phone:626-447-0934
Mailing Address - Fax:626-447-6405
Practice Address - Street 1:624 W DUARTE RD
Practice Address - Street 2:STE 204
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007
Practice Address - Country:US
Practice Address - Phone:626-447-0934
Practice Address - Fax:626-447-6405
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA245741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice