Provider Demographics
NPI:1689795957
Name:LAMARCA, MICHAEL ALLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLAN
Last Name:LAMARCA
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 1:622 BODART ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-4923
Mailing Address - Country:US
Mailing Address - Phone:920-940-8034
Mailing Address - Fax:920-437-0984
Practice Address - Street 1:424 S MONROE AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-4054
Practice Address - Country:US
Practice Address - Phone:920-437-7206
Practice Address - Fax:920-437-0984
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0263711223G0001X
WI5598-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice