Individual
DR. MICHAEL E STATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1227 CEDARS CT, CHARLOTTESVILLE, VA 22903-4800
(434) 296-8043
Mailing address
1227 CEDARS CT, CHARLOTTESVILLE, VA 22903-4800
(434) 296-8043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
04010007444
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099305
ANTHEM PROVIDER NUMBER
VA
01
—
892536
UNITED CONCORDIA GROUP #
VA
Enumeration date
02/28/2006
Last updated
07/08/2007
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