Provider Demographics
NPI:1770786923
Name:DEAN, MICHAEL E (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:DEAN
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 1:503 FM 1431
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-5211
Mailing Address - Country:US
Mailing Address - Phone:830-693-8283
Mailing Address - Fax:830-693-6549
Practice Address - Street 1:503 FM 1431 EAST
Practice Address - Street 2:SUITE 203
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5211
Practice Address - Country:US
Practice Address - Phone:830-693-8283
Practice Address - Fax:830-693-6549
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice