Individual
DR. MICHAEL RICHARD MUSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
610 S. TILLOSTON AVE., #205, MUNCIE, IN 47304
(765) 288-5527
(765) 288-6119
Mailing address
610 S TILLOTSON AVE, #205, MUNCIE, IN 47304-4430
(765) 288-5527
(765) 288-6119
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12010472A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200408960A
—
IN
Enumeration date
03/08/2007
Last updated
07/08/2007
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