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General NPI Number Information
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NPI Number | 1538401096
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Entity Type | Organization
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Legal Business Name | MICHAEL SHAYE, D.D.S., INC., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/22/2013
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Last Update Date | 03/22/2013
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Provider Practice Location Address
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Address Line | 327 W MANCHESTER BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90301-1107
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Country | US
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Telephone | 310-491-2872
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Fax |
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Provider Business Mailing Address
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Address Line | 327 W MANCHESTER BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90301-1107
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Country | US
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Telephone | 310-491-2872
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MICHAEL SHAYE
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Credential | D.D.S.
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Telephone | 310-491-2872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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