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General NPI Number Information
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NPI Number | 1578136537
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Entity Type | Individual
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Provider Name | GEORGE DAVID MICHAEL DDS
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Gender | Male
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 4175 S ALAMO AVE
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City | DAVIS MONTHAN AFB
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State | AZ
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Zip | 85707-4402
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Country | US
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Telephone | 520-228-2615
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Fax |
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Provider Business Mailing Address
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Address Line | 12601 N GRANVILLE CANYON WAY
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City | ORO VALLEY
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State | AZ
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Zip | 85755-8936
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Country | US
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Telephone | 847-280-0471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | D011122
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License Number State | AZ
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