Provider Demographics
NPI:1205948684
Name:ATKINSON, MICHELE N (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:N
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 PLATINUM CIR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3663
Mailing Address - Country:US
Mailing Address - Phone:413-584-1722
Mailing Address - Fax:413-584-5835
Practice Address - Street 1:69 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2402
Practice Address - Country:US
Practice Address - Phone:413-584-1722
Practice Address - Fax:413-584-5835
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18386122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist