Gannon, Michael Lawrence

Gannon, Michael Lawrence is an sole proprietor health care provider with primary practice located at 138 Church St Ne , Vienna VA 22180-4543. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Gannon, Michael Lawrence can be contacted via phone (703) 938-6022.

Contact Information

Primary practice address
138 Church St Ne Vienna VA 22180-4543
Fax: (703) 938-6039
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 6214 Virginia

Profile Details

NPI number 1316096480
LBN Legal business name Gannon, Michael Lawrence
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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