# MICHAELIAN ENDODONTIC DENTAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bay Area Endodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578012027
- **Authorized official:** MARSHALL J MICHAELIAN D.M.D (OWNER/PRESIDENT)
- **Authorized official phone:** (650) 994-2710

## Contact information

- **Practice address:** 341 GELLERT BLVD STE C, DALY CITY, CA 94015-2616
- **Practice address phone:** (650) 994-2710
- **Mailing address:** 341 GELLERT BLVD STE C, DALY CITY, CA 94015-2616
- **Mailing address phone:** (650) 994-2710
- **Mailing address fax:** (650) 994-5313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | Yes |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2016
- **Last updated:** 09/26/2016