Provider Demographics
NPI:1831428929
Name:BACHMAN, MICHAEL EUGENE JR (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:BACHMAN
Suffix:JR
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 1:700 N SANDERS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3528
Mailing Address - Country:US
Mailing Address - Phone:760-375-8512
Mailing Address - Fax:
Practice Address - Street 1:700 N SANDERS ST
Practice Address - Street 2:SUITE B
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3528
Practice Address - Country:US
Practice Address - Phone:760-375-8512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59066122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist