Provider Demographics
NPI:1063567022
Name:ALSPAUGH, MICHAEL F (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:F
Last Name:ALSPAUGH
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 1:609 S KELLY AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5659
Mailing Address - Country:US
Mailing Address - Phone:405-340-3880
Mailing Address - Fax:
Practice Address - Street 1:609 S KELLY AVE
Practice Address - Street 2:SUITE A1
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5659
Practice Address - Country:US
Practice Address - Phone:405-340-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist