Provider Demographics
NPI:1861101370
Name:WARD, MICHAEL ALAN II (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:WARD
Suffix:II
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 1:9832 BEAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1929
Mailing Address - Country:US
Mailing Address - Phone:407-704-0730
Mailing Address - Fax:
Practice Address - Street 1:2190 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1861
Practice Address - Country:US
Practice Address - Phone:863-535-5705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27615122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist