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General NPI Number Information
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NPI Number | 1902963291
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Entity Type | Organization
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Legal Business Name | MICHAEL LEVY DDS PC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 59 E LEXINGTON
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City | PHOENIX
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State | AZ
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Zip | 85012
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Country | US
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Telephone | 602-274-9242
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Fax | 602-274-3433
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Provider Business Mailing Address
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Address Line | 59 E LEXINGTON
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City | PHOENIX
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State | AZ
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Zip | 85012
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Country | US
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Telephone | 602-274-9242
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Fax | 602-274-3433
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Authorized Official
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Title or Position | DENTIST OWNER PRESIDENT
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Name | DR. MICHAEL I LEVY
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Credential | DDS
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Telephone | 602-274-9242
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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 | 00712 COLORADO DENTI
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8098 MINNESOTA DENTI
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2246 ARIZONA DENTIST
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License Number State | AZ
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