Basic Information
Provider Information
NPI: 1497859672
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRENCH
FirstName: DAVID
MiddleName: WILLIAM
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1451 EAST LANSING DRIVE
Address2: SUITE #225
City: EAST LANSING
State: MI
PostalCode: 48823
CountryCode: US
TelephoneNumber: 5173328877
FaxNumber: 5173328848
Practice Location
Address1: 1451 E LANSING DRIVE
Address2: SUITE #225
City: EAST LANSING
State: MI
PostalCode: 48823
CountryCode: US
TelephoneNumber: 5173328877
FaxNumber: 5173328848
Other Information
ProviderEnumerationDate: 09/11/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X8470MIY Dental ProvidersDentistGeneral Practice

No ID Information.


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