Dietz, Michael Wayne

Dietz, Michael Wayne is an sole proprietor health care provider with primary practice located at 3397 Middleford Dr , Cookeville TN 38506-6120. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Dietz, Michael Wayne can be contacted via phone (931) 372-1647.

Contact Information

Primary practice address
3397 Middleford Dr Cookeville TN 38506-6120
Phone: (931) 372-1647
Fax: (931) 537-2215
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DS2839 Tennessee

Profile Details

NPI number 1326022872
LBN Legal business name Dietz, Michael Wayne
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated Oct 25th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326022872 NPPES
Montana Other 2383 DENTAL LICENSE
Montana Other DS2839 DENTAL LICENSE

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