Individual
DEANNA R MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6037
Mailing address
14 WAGNER FARM LN, MILLSTONE TOWNSHIP, NJ 08535-9421
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02533800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2012
Last updated
09/26/2023
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