Provider Demographics
NPI:1902238785
Name:ECCLES -MAJOR, MICHELLE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:L
Last Name:ECCLES -MAJOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 TREYBORNE CIR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390-2832
Mailing Address - Country:US
Mailing Address - Phone:249-926-8635
Mailing Address - Fax:
Practice Address - Street 1:1664 TREYBORNE CIR
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-2832
Practice Address - Country:US
Practice Address - Phone:248-926-8635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901015224122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist