Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 0-119170 | MI |
NPI | 1477563476 |
---|---|
Provider Name | Dr. Michael G Maihofer |
First Address | Roseville, MI 48066 |
Second Address | Roseville, MI 48066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |