Provider Demographics
NPI:1033102207
Name:RECUBER, MICHAEL III (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:RECUBER
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9270 E THOMPSON PEAK PKWY
Mailing Address - Street 2:LOT 361
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4538
Mailing Address - Country:US
Mailing Address - Phone:480-342-8441
Mailing Address - Fax:
Practice Address - Street 1:8877 W UNION HILLS DR
Practice Address - Street 2:#E-500
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3008
Practice Address - Country:US
Practice Address - Phone:623-815-2626
Practice Address - Fax:623-815-5218
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ52621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice