Organization
CHILDREN'S DENTAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDRE MICHAELIAN DDS (PRESIDENT)
(702) 220-9100
Entity
Organization
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
1223P0221X
Pediatric Dentistry
Primary
3076
NV
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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