Individual
MICHAEL STEVEN POLLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
455 S C ST, OXNARD, CA 93030-5917
(800) 579-3783
Mailing address
1565 FLYNN RD APT 6216, CAMARILLO, CA 93012-5832
(805) 908-1717
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
57996
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57996
STATE LICENSE
CA
Enumeration date
01/08/2009
Last updated
11/18/2009
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