Individual
PHYLICIA GAELLE MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
635 PILOT HOUSE DR, NEWPORT NEWS, VA 23606-1980
(804) 651-8414
Mailing address
2106 RADIUS WAY, NEWPORT NEWS, VA 23602-9086
(804) 651-8414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401419051
VA
1223G0001X
General Practice Dentistry
DEN200280
DC
Other
Enumeration date
03/28/2023
Last updated
02/25/2025
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