Provider Demographics
NPI:1124124615
Name:FESLER, MICHAEL JOHN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:FESLER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E FM 544 STE 98
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4078
Mailing Address - Country:US
Mailing Address - Phone:972-424-2221
Mailing Address - Fax:972-424-3088
Practice Address - Street 1:160 E FM 544 STE 98
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4078
Practice Address - Country:US
Practice Address - Phone:972-424-2221
Practice Address - Fax:972-424-3088
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20599OtherTEXAS LICENSE