Provider Demographics
NPI:1952783441
Name:RANKE, MICHELLE CARDINAL (DDS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CARDINAL
Last Name:RANKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-2931
Mailing Address - Country:US
Mailing Address - Phone:248-736-7953
Mailing Address - Fax:
Practice Address - Street 1:2900 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-4452
Practice Address - Country:US
Practice Address - Phone:810-789-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315071526122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist