Doctor Name: | MR. MICHAEL GERALD COON |
NPI Number: | 1598955247 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 3232 W Houghton Lake Drive Houghton Lake, MI - 48629 |
Business Phone Number: | 9893666971 |
Business Fax Number: | |
Mailing Address: | 3232 W Houghton Lake Drive, HOUGHTON LAKE |
State: | MI |
Postal Code: | 48629 |
Phone Number: | 9893666971 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2007 |
NPI Last Update Date: | 07/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 126900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dental Laboratory Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary. |