Provider Demographics
NPI:1285922682
Name:MICHAEL I MUUL DDS PA
Entity type:Organization
Organization Name:MICHAEL I MUUL DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUUL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PA
Authorized Official - Phone:410-290-7757
Mailing Address - Street 1:6798 OAK HALL LN
Mailing Address - Street 2:SUITE A1
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-4892
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6798 OAK HALL LN
Practice Address - Street 2:SUITE A1
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4892
Practice Address - Country:US
Practice Address - Phone:410-290-7757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD465RMedicare UPIN