Provider Demographics
NPI:1083873640
Name:DEMO, MICHAEL MCHANEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MCHANEY
Last Name:DEMO
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:550 PHARR RD NE
Mailing Address - Street 2:SUITE 325
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-3428
Mailing Address - Country:US
Mailing Address - Phone:404-233-8221
Mailing Address - Fax:404-233-5783
Practice Address - Street 1:550 PHARR RD NE
Practice Address - Street 2:SUITE 325
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-3428
Practice Address - Country:US
Practice Address - Phone:404-233-8221
Practice Address - Fax:404-233-5783
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-08
Last Update Date:2016-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GADN0143191223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery