Provider Demographics
NPI:1972551810
Name:REICH, MICHAEL R (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:REICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:R
Other - Last Name:REICH,DDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7110 VENOY RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1637
Mailing Address - Country:US
Mailing Address - Phone:734-522-6340
Mailing Address - Fax:
Practice Address - Street 1:7110 VENOY RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1637
Practice Address - Country:US
Practice Address - Phone:734-522-6340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI138051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice