| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MICHELLE PRATHER | 1346502465 | 2023-11-11 |
Michelle Prather is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1346502465. Registration indicates Michelle Prather is a provider of access to dentists-general services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist, ) (Dental, ) (Dentist, Dental Providers)
| Entity Type | Individual |
| Provider Name | Michelle Prather D.M.D |
| Practice Office Address | 316 MDG/MALCOLM GROW MEDICAL CLINICS & SURGERY CENTER 1060 W. PERIMETER ROAD, SUITE 3K43 JB ANDREWS, MD US |
| Practice Office Telephone | 6189609065 |
| Mailing Address | 316 MDG/MALCOLM GROW MEDICAL CLINICS & SURGERY CENTER 1060 W. PERIMETER ROAD, SUITE 3K43 JB ANDREWS, MD 207626600 US |
| Business Telephone | 6189609065 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 220 Falcon Pkwy 21 MDS - Dental Clinic | Schriever AFB, CO 809125005 | 7195674293 |
| 801 W Saint Louis St | Lebanon, IL 622541320 | 6189609065 |
| 13123 E 16th Ave | Aurora, CO 800457106 | 6189609065 |
| 48th Medical Group RAF Lakenheath Unit 5115 | APO, AE 094615115 | 3142268317 |
| Code | Practice | License No State |
|---|---|---|
| 122300000X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist Dental Dentist Dental Providers | 019.028636
IL |
| 019-028636 | OTHER | IL | IL LICENSE |