Provider Demographics
NPI:1588769376
Name:DANZE, MICHAEL LEOPOLD (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEOPOLD
Last Name:DANZE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10610 INDEPENDENCE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-2880
Mailing Address - Country:US
Mailing Address - Phone:704-845-2477
Mailing Address - Fax:704-845-0882
Practice Address - Street 1:10610 INDEPENDANCE POINTE PARKWAY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105
Practice Address - Country:US
Practice Address - Phone:704-845-2477
Practice Address - Fax:704-845-0882
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001359988122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist