Mcdaniel, Michael David

Mcdaniel, Michael David is an sole proprietor health care provider with primary practice located at 501 Park Ave , Indianola MS 38751-2355. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mcdaniel, Michael David can be contacted via phone (662) 887-1272.

Contact Information

Primary practice address
501 Park Ave Indianola MS 38751-2355
Fax: (662) 887-6453
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 273893 Mississippi

Profile Details

NPI number 1417048182
LBN Legal business name Mcdaniel, Michael David
Credentials D.M.D.P.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2006
Last updated Jul 9th, 2007 - about 18 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 1417048182 NPPES
Mississippi MEDICAID 00660041

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