Provider Demographics
NPI:1730398439
Name:DORSCH, MICHELE LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LYNN
Last Name:DORSCH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7012 GOLDENGATE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-4105
Mailing Address - Country:US
Mailing Address - Phone:513-624-6476
Mailing Address - Fax:
Practice Address - Street 1:6909 BURLINGTON PIKE
Practice Address - Street 2:SUITE A
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1618
Practice Address - Country:US
Practice Address - Phone:859-647-7068
Practice Address - Fax:859-647-7038
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY84751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice