Provider Demographics
NPI:1083835391
Name:YOUNG, MICHAEL LLOYD (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LLOYD
Last Name:YOUNG
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 1:39242 DEQUINDRE RD, SUITE 106
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4831
Mailing Address - Country:US
Mailing Address - Phone:248-689-9183
Mailing Address - Fax:248-689-6855
Practice Address - Street 1:39242 DEQUINDRE RD, SUITE 106
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4831
Practice Address - Country:US
Practice Address - Phone:248-689-9183
Practice Address - Fax:248-689-6855
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist