Provider Demographics
NPI:1073640397
Name:TRAMEL, MICHAEL T (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:TRAMEL
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 1:261 TRACE COLONY PARK DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157
Mailing Address - Country:US
Mailing Address - Phone:601-982-7212
Mailing Address - Fax:601-981-2362
Practice Address - Street 1:261 TRACE COLONY PARK DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157
Practice Address - Country:US
Practice Address - Phone:601-982-7212
Practice Address - Fax:601-981-2362
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2205851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice