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Provider Information for 1972639482



DR. MICHAEL J MINIHANE DDS

Gender: MALE

Individual NPI: 1972639482

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1972639482
Enumeration Date 2007-02-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 333 WAUKEGAN RD
GLENVIEW, IL 60025
United States

Phone: 847-729-1626 | Fax:
View Map External Link
Primary Practice Address 333 WAUKEGAN RD SUITE A
GLENVIEW, IL 60025
United States

Phone: 847-729-1626 | Fax:
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist IL
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location