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General NPI Number Information
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NPI Number | 1689739302
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Entity Type | Individual
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Provider Name | ALLEN G MICHELS DDS
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10883 TELEGRAPH RD
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City | VENTURA
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State | CA
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Zip | 93004-1272
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Country | US
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Telephone | 805-647-1322
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Fax | 805-647-3116
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Provider Business Mailing Address
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Address Line | 5250 LOUISE AVE
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City | ENCINO
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State | CA
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Zip | 91316-2535
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Country | US
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Telephone | 818-203-3545
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Fax | 818-990-1291
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19777
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License Number State | CA
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