Provider Demographics
NPI:1538196894
Name:SHULER, MICHELLE A (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:A
Last Name:SHULER
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 1:10367 TARA BLVD
Mailing Address - Street 2:ALLSMILES DENTISTRY, P.C.
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-6536
Mailing Address - Country:US
Mailing Address - Phone:770-472-7070
Mailing Address - Fax:770-472-0007
Practice Address - Street 1:10367 TARA BLVD
Practice Address - Street 2:ALLSMILES DENTISTRY, P.C.
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-6536
Practice Address - Country:US
Practice Address - Phone:770-472-7070
Practice Address - Fax:770-472-0007
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0118261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00929299BMedicaid