Provider Demographics
NPI:1306870282
Name:WOODS, MICHELLE ELISE (DDS)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELISE
Last Name:WOODS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 GAMBRILLS ROAD
Mailing Address - Street 2:C
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054
Mailing Address - Country:US
Mailing Address - Phone:410-923-0373
Mailing Address - Fax:410-923-1093
Practice Address - Street 1:325 GAMBRILLS ROAD
Practice Address - Street 2:C
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054
Practice Address - Country:US
Practice Address - Phone:410-923-0373
Practice Address - Fax:410-923-1093
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12026122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist