person
Michael Tadayuki Miyamoto, DDS
Student in an Organized Health Care Education/Training Program in Green Bay, Wisconsin
NPI 1013531656

Michael Tadayuki Miyamoto is a Student in an Organized Health Care Education/Training Program based in Green Bay, WI. Michael Tadayuki Miyamoto practices in Green Bay, WI and has the professional credentials of DDS. The NPI Number for Michael Tadayuki Miyamoto is 1013531656 and holds a License No. (Wisconsin).

The current practice location address for Michael Tadayuki Miyamoto is 2851 University Ave, Green Bay, WI and can be reached out via phone at 414-384-2000.

Location: 2851 University Ave, Green Bay, WI, 54311-5855
person
Provider Profile Details
NPI Number
1013531656
Provider Name
Michael Tadayuki Miyamoto
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2851 University Ave, Green Bay, WI, 54311-5855
Phone Number
414-384-2000
Fax Number
Provider Enumeration Date
05/29/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2851 University Ave
City
State
Zip
54311-5855
Phone Number
414-384-2000
Fax Number
person
Provider Business Mailing Address Details
Address
2851 University Ave
City
State
Zip
54311-5855
Phone Number
414-384-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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