Healthcare Provider Details

I. General information

NPI: 1326576638
Provider Name (Legal Business Name): MICHAEL G WINKELMAN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3061 W APACHE TRL STE 1
APACHE JUNCTION AZ
85120-3625
US

IV. Provider business mailing address

3061 W APACHE TRL STE 1
APACHE JUNCTION AZ
85120-3625
US

V. Phone/Fax

Practice location:
  • Phone: 480-671-1111
  • Fax: 480-671-1657
Mailing address:
  • Phone: 480-671-1111
  • Fax: 480-671-1657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number8594
License Number StateAZ

VIII. Authorized Official

Name: MRS. MICHELLE RENEE MCMAHAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 480-671-1111