Individual
DR. MICHAEL DERRILL HABLITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
304 1/2 MADISON ST, PORT CLINTON, OH 43452-1921
(419) 734-2175
Mailing address
304 1/2 MADISON ST, PORT CLINTON, OH 43452-1921
(419) 734-2175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
OH15756
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0712732
—
OH
Enumeration date
03/25/2008
Last updated
03/26/2008
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