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Organization

THOMAS R. MICHAELIS, D.D.S., M.D., INC, RYAN M. KRIWANEK, D.D.S., M.D.

Active
Other names
Newport Oral Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS RAYMOND MICHAELIS DDS, MD (PARTNER)
(949) 760-1661
Entity
Organization

Contact information

Practice address
1401 AVOCADO AVE. SUITE 506, NEWPORT BEACH, CA 92660
(949) 760-1661
(949) 760-8016
Mailing address
1401 AVOCADO AVE. SUITE 506, NEWPORT BEACH, CA 92660
(949) 760-1661
(949) 760-8016

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22313
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
38855
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
42745
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
58948
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)

Other

Enumeration date
10/21/2016
Last updated
01/23/2020
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