Provider Demographics
NPI:1134211022
Name:GETSCHMAN, GEORGE RICHARD (DDS)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:RICHARD
Last Name:GETSCHMAN
Suffix:
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 1:630 N OLD WOODWARD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3860
Mailing Address - Country:US
Mailing Address - Phone:248-646-2040
Mailing Address - Fax:
Practice Address - Street 1:630 N OLD WOODWARD AVE STE 202
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3860
Practice Address - Country:US
Practice Address - Phone:248-646-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010138691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice