MEDICARE: DR. GEORGE GEORGES CHABIAA D.D.S.,

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	17752	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922173806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE GEORGES CHABIAA D.D.S.,

Provider Business Mailing Address
First Line	:	1052 E WEST MAPLE RD
Second Line	:
City	:	WALLED LAKE
State	:	MI
Zip	:	48390-3571
Country	:	US
Telephone Number	:	248-624-5533
Fax Number	:

Provider Business Practice Location Address
First Line	:	1052 E WEST MAPLE RD
Second Line	:
City	:	WALLED LAKE
State	:	MI
Zip	:	48390-3571
Country	:	US
Telephone Number	:	248-624-5533
Fax Number	:

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

Provider Enumeration Date	:	11/23/2006
Last Update Date	:	01/13/2018

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