Provider Demographics
NPI:1073704284
Name:DELMONT, MICHAEL FLOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FLOYD
Last Name:DELMONT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 W 3RD ST
Mailing Address - Street 2:SUITE 580 WEST
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-6101
Mailing Address - Country:US
Mailing Address - Phone:310-652-7742
Mailing Address - Fax:310-652-7018
Practice Address - Street 1:8635 W 3RD ST
Practice Address - Street 2:SUITE 580 WEST
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6101
Practice Address - Country:US
Practice Address - Phone:310-652-7742
Practice Address - Fax:310-652-7018
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice