Provider Demographics
NPI:1003926254
Name:GEORGESCU, MICHAEL NICOLAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NICOLAE
Last Name:GEORGESCU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:MIHAIL
Other - Middle Name:NICOLAE
Other - Last Name:GEORGESCU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:16485 COLLINS AVE
Mailing Address - Street 2:TOWER #3 AP#2832
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4535
Mailing Address - Country:US
Mailing Address - Phone:305-919-7551
Mailing Address - Fax:
Practice Address - Street 1:3200 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-1835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL115941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice