Hazel, Michael C

Hazel, Michael C is an individual health care provider with primary practice located at 18607 Willamette Dr , West Linn OR 97068-1705. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Hazel, Michael C can be contacted via phone (503) 635-3588.

Contact Information

Primary practice address
18607 Willamette Dr West Linn OR 97068-1705
Phone: (503) 635-3588
Fax: (503) 635-3909
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5121 Oregon

Profile Details

NPI number 1033111216
LBN Legal business name Hazel, Michael C
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1033111216 NPPES
Alabama MEDICAID DD1020R

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