Individual
DR. PAUL L. MICHAELIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2503 W. SHAW, SUITE 105, FRESNO, CA 93711-3309
(155) 922-9450
(155) 922-6128
Mailing address
2503 W. SHAW, SUITE 105, FRESNO, CA 93711-3309
(155) 922-9450
(155) 922-6128
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
24486
CA
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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