MEDICARE: DR. MICHELE S TRATOS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2310	NV

General Provider Information

NPI Number	:	1619034295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE S TRATOS DDS

Provider Business Mailing Address
First Line	:	3057 E WARM SPRINGS RD
Second Line	:	SUITE 300
City	:	LAS VEGAS
State	:	NV
Zip	:	89120
Country	:	US
Telephone Number	:	702-369-8730
Fax Number	:	702-369-0194

Provider Business Practice Location Address
First Line	:	3057 E WARM SPRINGS RD
Second Line	:	SUITE 300
City	:	LAS VEGAS
State	:	NV
Zip	:	89120
Country	:	US
Telephone Number	:	702-369-8730
Fax Number	:	702-369-0194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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