Individual
DR. ANDRE MICHAELIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8430 W LAKE MEAD BLVD, SUITE 150, LAS VEGAS, NV 89128-7672
(702) 220-9100
(702) 220-9104
Mailing address
8430 W LAKE MEAD BLVD, SUITE 150, LAS VEGAS, NV 89128-7672
(702) 220-9100
(702) 220-9104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3076
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002202034
—
NV
Enumeration date
01/30/2007
Last updated
02/13/2020
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