Provider Demographics
NPI:1447361613
Name:GIESLER, MICHAEL LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:GIESLER
Suffix:
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 1:1 BAYOU DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551-3402
Mailing Address - Country:US
Mailing Address - Phone:903-796-9051
Mailing Address - Fax:903-799-5475
Practice Address - Street 1:1 BAYOU DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551-3402
Practice Address - Country:US
Practice Address - Phone:903-796-9051
Practice Address - Fax:903-799-5475
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice