Provider Demographics
NPI:1417234303
Name:AZNAVOUR, MICHAEL LEON (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEON
Last Name:AZNAVOUR
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 1:23809 VALLEY OAK CT
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-3747
Mailing Address - Country:US
Mailing Address - Phone:661-313-5338
Mailing Address - Fax:
Practice Address - Street 1:23809 VALLEY OAK CT
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-3747
Practice Address - Country:US
Practice Address - Phone:661-313-5338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA605111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice