Individual
DR. JERRY D. MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4TH AND WEST VIRGINIA, BLDG 500 HARPER DENTAL CLINIC, FT WOOD, MO 65473
(573) 596-0408
(573) 596-0314
Mailing address
25279 MCCLURG RD, VERSAILLES, MO 65084-5769
(573) 372-2786
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011804
MO
1223G0001X
General Practice Dentistry
4931
KS
Other
Enumeration date
04/04/2006
Last updated
07/08/2007
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